Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $5,888.44 / $10,964.78	Facility		$1,380.38	$5,888.44	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,000.00 / $4,265.80	Professional		$724.44	$1,000.00	$4,265.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $2,884.03 / $7,943.28	Facility		$1,000.00	$2,884.03	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $794.33 / $1,412.54	Professional		$616.60	$794.33	$1,412.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,288.25	Facility		$1,047.13	$1,047.13	$1,288.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Professional		$891.25	$891.25	$891.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,047.13 / $21,379.62	Facility		$954.99	$1,047.13	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,047.13 / $1,778.28	Professional		$691.83	$1,047.13	$1,778.28
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,047.13 / $21,379.62	Facility		$954.99	$1,047.13	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,047.13 / $1,862.09	Professional		$691.83	$1,047.13	$1,862.09
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 / $562.34 / $2,951.21	Facility		$100.00	$562.34	$2,951.21
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $933.25 / $1,819.70	Professional		$794.33	$933.25	$1,819.70
United Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $4,265.80 / $7,244.36	Facility		$1,778.28	$4,265.80	$7,244.36
United Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $870.96 / $1,513.56	Professional		$676.08	$870.96	$1,513.56