Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $7,585.78 / $12,022.64	Facility		$1,318.26	$7,585.78	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $954.99 / $6,165.95	Professional		$776.25	$954.99	$6,165.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $3,548.13 / $16,982.44	Facility		$2,238.72	$3,548.13	$16,982.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $851.14 / $1,513.56	Professional		$691.83	$851.14	$1,513.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $2,630.27	Facility		$1,023.29	$1,023.29	$2,630.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $870.96 / $870.96	Professional		$870.96	$870.96	$870.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $2,137.96 / $21,379.62	Facility		$1,949.84	$2,137.96	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,047.13 / $1,698.24	Professional		$691.83	$1,047.13	$1,698.24
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $2,137.96 / $21,379.62	Facility		$1,949.84	$2,137.96	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,071.52 / $1,819.70	Professional		$707.95	$1,071.52	$1,819.70
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 / $1,148.15 / $5,128.61	Facility		$100.00	$1,148.15	$5,128.61
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $851.14 / $1,698.24	Professional		$741.31	$851.14	$1,698.24
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $4,265.80 / $7,413.10	Facility		$1,995.26	$4,265.80	$7,413.10
United Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $891.25 / $1,548.82	Professional		$707.95	$891.25	$1,548.82