Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,292.00 / $7,645.00 / $17,682.00	Facility		$2,292.00	$7,645.00	$17,682.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,462.02 / $2,232.71 / $2,774.70	Professional		$1,462.02	$2,232.71	$2,774.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,794.51 / $17,502.61 / $31,141.30	Facility		$6,794.51	$17,502.61	$31,141.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,189.46 / $2,539.81 / $3,772.65	Professional		$2,189.46	$2,539.81	$3,772.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,168.11 / $21,139.08 / $50,371.43	Facility		$2,168.11	$21,139.08	$50,371.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,168.11 / $32,521.65 / $55,977.89	Professional		$2,168.11	$32,521.65	$55,977.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,571.00 / $21,571.00 / $21,571.00	Facility		$21,571.00	$21,571.00	$21,571.00
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,604.13 / $2,604.13 / $2,604.13	Facility		$2,604.13	$2,604.13	$2,604.13
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $3,657.46 / $3,657.46 / $10,842.01	Professional		$3,657.46	$3,657.46	$10,842.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $60.00 / $60.00	Professional		$30.00	$60.00	$60.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,480.00 / $3,086.00 / $6,111.00	Facility		$1,480.00	$3,086.00	$6,111.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,873.30 / $2,973.34 / $4,549.39	Professional		$1,873.30	$2,973.34	$4,549.39