Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,195.79 / $6,875.96 / $14,500.00	Facility		$2,195.79	$6,875.96	$14,500.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,711.34 / $1,962.86 / $4,101.46	Professional		$1,711.34	$1,962.86	$4,101.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,405.00 / $41,878.69 / $76,926.81	Facility		$3,405.00	$41,878.69	$76,926.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,563.66 / $2,173.48 / $3,452.92	Professional		$1,563.66	$2,173.48	$3,452.92
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $2,285.04 / $2,285.04 / $2,285.04	Professional		$2,285.04	$2,285.04	$2,285.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,780.43 / $1,942.28 / $2,828.24	Facility		$1,780.43	$1,942.28	$2,828.24
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,988.00 / $2,094.62 / $2,665.88	Professional		$1,988.00	$2,094.62	$2,665.88
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 $1,991.58 / $2,761.08 / $3,987.06	Professional		$1,991.58	$2,761.08	$3,987.06
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,274.10 / $2,274.10 / $2,274.10	Facility		$2,274.10	$2,274.10	$2,274.10
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,999.40 / $2,784.87 / $3,987.06	Professional		$1,999.40	$2,784.87	$3,987.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $216.68 / $1,400.62 / $2,391.65	Professional		$216.68	$1,400.62	$2,391.65
United Facility/Professional Facility Modifier Low / Median / High Price $4,873.00 / $10,529.00 / $15,469.00	Facility		$4,873.00	$10,529.00	$15,469.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,653.44 / $2,538.82 / $4,155.39	Professional		$1,653.44	$2,538.82	$4,155.39