Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $5,888.44 / $10,964.78	Facility		$1,621.81	$5,888.44	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,445.44 / $4,168.69	Professional		$1,122.02	$1,445.44	$4,168.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $4,365.16 / $16,982.44	Facility		$2,238.72	$4,365.16	$16,982.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,380.38 / $2,187.76	Professional		$1,071.52	$1,380.38	$2,187.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,445.44	Facility		$1,230.27	$1,230.27	$1,445.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,698.24 / $2,454.71	Professional		$1,174.90	$1,698.24	$2,454.71
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,698.24 / $2,570.40	Professional		$1,096.48	$1,698.24	$2,570.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $10,715.19	Facility		$100.00	$100.00	$10,715.19
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,380.38 / $2,570.40	Professional		$1,174.90	$1,380.38	$2,570.40
United Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $6,760.83 / $11,220.18	Facility		$3,890.45	$6,760.83	$11,220.18
United Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,412.54 / $2,238.72	Professional		$933.25	$1,412.54	$2,238.72