Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,925.00 / $6,021.00 / $11,627.00	Facility		$1,925.00	$6,021.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,177.73 / $1,355.53 / $2,719.89	Professional		$1,177.73	$1,355.53	$2,719.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,142.00 / $14,428.74 / $24,745.60	Facility		$4,142.00	$14,428.74	$24,745.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,019.87 / $1,396.33 / $2,209.04	Professional		$1,019.87	$1,396.33	$2,209.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,242.22 / $1,355.15 / $1,973.28	Facility		$1,242.22	$1,355.15	$1,973.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,240.27 / $1,461.44 / $1,860.01	Professional		$1,240.27	$1,461.44	$1,860.01
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
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,351.79 / $1,860.02 / $2,587.03	Professional		$1,351.79	$1,860.02	$2,587.03
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,585.02 / $1,585.02 / $1,585.02	Facility		$1,585.02	$1,585.02	$1,585.02
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,395.01 / $1,905.60 / $2,551.04	Professional		$1,395.01	$1,905.60	$2,551.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $144.74 / $990.91 / $1,678.91	Professional		$144.74	$990.91	$1,678.91
United Facility/Professional Facility Modifier Low / Median / High Price $3,206.00 / $6,231.00 / $10,075.00	Facility		$3,206.00	$6,231.00	$10,075.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,103.53 / $1,704.32 / $2,865.88	Professional		$1,103.53	$1,704.32	$2,865.88