Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $5,888.44 / $8,317.64	Facility		$3,311.31	$5,888.44	$8,317.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $2,951.21 / $4,168.69	Professional		$2,398.83	$2,951.21	$4,168.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $3,715.35 / $6,456.54	Facility		$3,235.94	$3,715.35	$6,456.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $912.01 / $4,570.88	Professional		$239.88	$912.01	$4,570.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $41,686.94 / $72,443.60	Facility		$3,235.94	$41,686.94	$72,443.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $4,265.80 / $54,954.09 / $97,723.72	Professional		$4,265.80	$54,954.09	$97,723.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $2,290.87 / $12,022.64	Facility		$2,290.87	$2,290.87	$12,022.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $4,073.80 / $4,466.84	Professional		$2,041.74	$4,073.80	$4,466.84
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $3,630.78 / $14,454.40	Facility		$2,344.23	$3,630.78	$14,454.40
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,041.74 / $2,041.74	Professional		$2,041.74	$2,041.74	$2,041.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $3,162.28 / $4,365.16	Professional		$2,630.27	$3,162.28	$4,365.16
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $4,168.69 / $4,168.69	Facility		$4,168.69	$4,168.69	$4,168.69
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $3,890.45 / $8,128.31	Professional		$2,951.21	$3,890.45	$8,128.31
United Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $3,162.28 / $3,467.37	Facility		$1,258.93	$3,162.28	$3,467.37
United Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,089.30 / $3,981.07	Professional		$1,479.11	$2,089.30	$3,981.07