Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,880.00 / $6,192.00 / $9,000.00	Facility		$2,880.00	$6,192.00	$9,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,520.00 / $2,880.00 / $4,320.00	Professional		$2,520.00	$2,880.00	$4,320.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,178.80 / $3,888.00 / $6,370.92	Facility		$3,178.80	$3,888.00	$6,370.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,440.00 / $1,742.40 / $4,993.20	Professional		$1,440.00	$1,742.40	$4,993.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,600.00 / $4,500.00 / $5,400.00	Facility		$3,600.00	$4,500.00	$5,400.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $4,680.00 / $4,860.00 / $8,640.00	Professional		$4,680.00	$4,860.00	$8,640.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,212.82 / $3,706.56 / $20,545.20	Facility		$3,212.82	$3,706.56	$20,545.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,643.36 / $2,755.54 / $6,974.75	Professional		$1,643.36	$2,755.54	$6,974.75
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $3,212.82 / $3,706.56 / $24,270.71	Facility		$3,212.82	$3,706.56	$24,270.71
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,643.36 / $2,016.00 / $6,974.75	Professional		$1,643.36	$2,016.00	$6,974.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $2,970.00 / $3,915.00	Professional		$60.00	$2,970.00	$3,915.00
United Facility/Professional Facility Modifier Low / Median / High Price $4,320.00 / $4,320.00 / $4,320.00	Facility		$4,320.00	$4,320.00	$4,320.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,512.00 / $2,160.00 / $4,754.52	Professional		$1,512.00	$2,160.00	$4,754.52