Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $2,630.27 / $6,918.31	Facility		$2,344.23	$2,630.27	$6,918.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $2,344.23 / $2,884.03	Professional		$2,344.23	$2,344.23	$2,884.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $4,365.16 / $12,302.69	Facility		$2,344.23	$4,365.16	$12,302.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $169.82 / $2,290.87	Professional		$138.04	$169.82	$2,290.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $2,570.40 / $2,570.40	Facility		$2,570.40	$2,570.40	$2,570.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $2,570.40 / $3,890.45	Professional		$2,570.40	$2,570.40	$3,890.45
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $2,570.40 / $2,570.40	Facility		$2,570.40	$2,570.40	$2,570.40
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $2,570.40 / $3,890.45	Professional		$2,570.40	$2,570.40	$3,890.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,258.93 / $1,479.11	Professional		$977.24	$1,258.93	$1,479.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $2,818.38 / $2,818.38	Facility		$2,818.38	$2,818.38	$2,818.38
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $3,548.13 / $5,888.44	Professional		$2,691.53	$3,548.13	$5,888.44
United Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $2,344.23 / $2,344.23	Facility		$2,344.23	$2,344.23	$2,344.23
United Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $2,754.23 / $3,019.95	Professional		$2,344.23	$2,754.23	$3,019.95