Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $5,248.07 / $12,022.64	Facility		$645.65	$5,248.07	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $575.44 / $1,479.11	Professional		$436.52	$575.44	$1,479.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $3,715.35 / $15,135.61	Facility		$1,698.24	$3,715.35	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $512.86 / $933.25	Professional		$371.54	$512.86	$933.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $549.54 / $1,995.26	Facility		$549.54	$549.54	$1,995.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Professional		$467.74	$467.74	$467.74
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 $426.58 / $630.96 / $1,122.02	Professional		$426.58	$630.96	$1,122.02
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 $426.58 / $645.65 / $1,148.15	Professional		$426.58	$645.65	$1,148.15
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 $407.38 / $616.60 / $1,148.15	Professional		$407.38	$616.60	$1,148.15
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 $389.05 / $549.54 / $954.99	Professional		$389.05	$549.54	$954.99