Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $5,888.44 / $8,709.64	Facility		$3,090.30	$5,888.44	$8,709.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $3,162.28 / $6,456.54	Professional		$2,570.40	$3,162.28	$6,456.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $4,073.80 / $7,079.46	Facility		$3,548.13	$4,073.80	$7,079.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,995.26 / $5,248.07	Professional		$1,548.82	$1,995.26	$5,248.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,466.84 / $4,466.84 / $4,466.84	Facility		$4,466.84	$4,466.84	$4,466.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $5,248.07 / $5,248.07 / $5,248.07	Professional		$5,248.07	$5,248.07	$5,248.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $2,511.89 / $13,182.57	Facility		$2,511.89	$2,511.89	$13,182.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $3,235.94 / $6,918.31	Professional		$1,778.28	$3,235.94	$6,918.31
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $3,981.07 / $15,848.93	Facility		$2,570.40	$3,981.07	$15,848.93
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,884.03 / $6,918.31	Professional		$1,778.28	$2,884.03	$6,918.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $3,467.37 / $4,786.30	Professional		$2,884.03	$3,467.37	$4,786.30
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $4,677.35 / $4,677.35 / $4,677.35	Facility		$4,677.35	$4,677.35	$4,677.35
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $3,311.31 / $4,786.30 / $8,912.51	Professional		$3,311.31	$4,786.30	$8,912.51
United Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $3,467.37 / $3,890.45	Facility		$1,380.38	$3,467.37	$3,890.45
United Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,344.23 / $4,466.84	Professional		$1,621.81	$2,344.23	$4,466.84