Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $841.00 / $5,509.05 / $14,722.40	Facility		$841.00	$5,509.05	$14,722.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,000.00 / $3,824.00 / $4,541.00	Professional		$3,000.00	$3,824.00	$4,541.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,220.74 / $5,258.00 / $8,459.17	Facility		$4,220.74	$5,258.00	$8,459.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $800.00 / $1,912.00 / $4,780.00	Professional		$800.00	$1,912.00	$4,780.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,596.95 / $5,019.00 / $7,170.00	Facility		$3,596.95	$5,019.00	$7,170.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $4,063.00 / $6,214.00 / $11,472.00	Professional		$4,063.00	$6,214.00	$11,472.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,107.00 / $4,921.49 / $16,311.75	Facility		$3,107.00	$4,921.49	$16,311.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,186.88 / $3,107.00 / $9,261.00	Professional		$2,186.88	$3,107.00	$9,261.00
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $3,107.00 / $4,921.49 / $18,486.98	Facility		$3,107.00	$4,921.49	$18,486.98
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $2,186.88 / $3,107.00 / $10,402.94	Professional		$2,186.88	$3,107.00	$10,402.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,585.00 / $4,122.75 / $5,736.00	Professional		$3,585.00	$4,122.75	$5,736.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,007.60 / $2,868.00 / $6,312.95	Professional		$2,007.60	$2,868.00	$6,312.95