Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,264.00 / $6,251.00 / $11,581.00	Facility		$2,264.00	$6,251.00	$11,581.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,475.05 / $1,724.25 / $3,453.40	Professional		$1,475.05	$1,724.25	$3,453.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,315.00 / $16,655.00 / $29,882.70	Facility		$3,315.00	$16,655.00	$29,882.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $802.56 / $1,138.73 / $2,338.14	Professional		$802.56	$1,138.73	$2,338.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,566.77 / $2,010.83 / $2,670.63	Facility		$1,566.77	$2,010.83	$2,670.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,843.26 / $2,345.96 / $127,498.73	Professional		$1,843.26	$2,345.96	$127,498.73
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 $1,320.22 / $2,263.06 / $3,313.02	Professional		$1,320.22	$2,263.06	$3,313.02
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,999.50 / $1,999.50 / $1,999.50	Facility		$1,999.50	$1,999.50	$1,999.50
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,424.34 / $2,299.98 / $3,225.73	Professional		$1,424.34	$2,299.98	$3,225.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $216.49 / $1,204.35 / $2,094.66	Professional		$216.49	$1,204.35	$2,094.66
United Facility/Professional Facility Modifier Low / Median / High Price $4,070.00 / $8,440.00 / $13,382.00	Facility		$4,070.00	$8,440.00	$13,382.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,013.68 / $2,062.90 / $3,658.75	Professional		$1,013.68	$2,062.90	$3,658.75