Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $7,585.78 / $12,022.64	Facility		$2,137.96	$7,585.78	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,548.82 / $8,912.51	Professional		$1,174.90	$1,548.82	$8,912.51
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 $1,023.29 / $1,258.93 / $2,238.72	Professional		$1,023.29	$1,258.93	$2,238.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $1,995.26	Facility		$1,621.81	$1,621.81	$1,995.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Professional		$1,380.38	$1,380.38	$1,380.38
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 $1,096.48 / $1,621.81 / $2,754.23	Professional		$1,096.48	$1,621.81	$2,754.23
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 $1,122.02 / $1,621.81 / $2,884.03	Professional		$1,122.02	$1,621.81	$2,884.03
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 $1,230.27 / $1,412.54 / $2,818.38	Professional		$1,230.27	$1,412.54	$2,818.38
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 $1,071.52 / $1,380.38 / $2,398.83	Professional		$1,071.52	$1,380.38	$2,398.83