Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $5,248.07 / $8,511.38	Facility		$3,311.31	$5,248.07	$8,511.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $2,818.38 / $6,025.60	Professional		$2,691.53	$2,818.38	$6,025.60
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 $66.07 / $95.50 / $3,548.13	Professional		$66.07	$95.50	$3,548.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $4,073.80	Facility		$2,398.83	$2,398.83	$4,073.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $4,365.16 / $54,954.09 / $97,723.72	Professional		$4,365.16	$54,954.09	$97,723.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $2,290.87 / $7,413.10	Facility		$2,290.87	$2,290.87	$7,413.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $4,073.80 / $5,011.87	Professional		$2,290.87	$4,073.80	$5,011.87
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $3,630.78 / $7,413.10	Facility		$2,290.87	$3,630.78	$7,413.10
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $2,290.87 / $2,290.87	Professional		$2,290.87	$2,290.87	$2,290.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $1,949.84	Professional		$1,949.84	$1,949.84	$1,949.84
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $4,265.80 / $4,265.80	Facility		$4,265.80	$4,265.80	$4,265.80
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $3,715.35 / $7,079.46	Professional		$2,290.87	$3,715.35	$7,079.46
United Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $2,290.87 / $3,548.13	Facility		$1,258.93	$2,290.87	$3,548.13
United Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,089.30 / $3,548.13	Professional		$1,479.11	$2,089.30	$3,548.13