Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $8,912.51 / $12,302.69	Facility		$2,454.71	$8,912.51	$12,302.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,778.28 / $8,317.64	Professional		$1,380.38	$1,778.28	$8,317.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $4,073.80 / $15,135.61	Facility		$1,905.46	$4,073.80	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,513.56 / $2,691.53	Professional		$1,148.15	$1,513.56	$2,691.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $1,862.09 / $1,995.26	Facility		$1,862.09	$1,862.09	$1,995.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $1,584.89 / $1,584.89	Professional		$1,584.89	$1,584.89	$1,584.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $1,621.81 / $21,379.62	Facility		$1,479.11	$1,621.81	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,862.09 / $3,090.30	Professional		$1,288.25	$1,862.09	$3,090.30
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $1,621.81 / $21,379.62	Facility		$1,479.11	$1,621.81	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,949.84 / $3,311.31	Professional		$1,318.26	$1,949.84	$3,311.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $891.25 / $4,786.30	Facility		$100.00	$891.25	$4,786.30
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,584.89 / $3,162.28	Professional		$1,380.38	$1,584.89	$3,162.28
United Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $5,754.40 / $9,120.11	Facility		$2,137.96	$5,754.40	$9,120.11
United Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,584.89 / $2,754.23	Professional		$1,258.93	$1,584.89	$2,754.23