Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,904.07 / $6,955.82 / $16,526.71	Facility		$4,904.07	$6,955.82	$16,526.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,904.07 / $4,904.07 / $5,210.58	Professional		$4,904.07	$4,904.07	$5,210.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,240.79 / $3,721.17 / $11,953.68	Facility		$2,240.79	$3,721.17	$11,953.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,210.58 / $6,473.69 / $10,681.58	Professional		$5,210.58	$6,473.69	$10,681.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,974.04 / $1,974.04 / $2,710.67	Facility		$1,974.04	$1,974.04	$2,710.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,974.04 / $1,974.04 / $1,974.04	Professional		$1,974.04	$1,974.04	$1,974.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,210.58 / $5,210.58 / $5,210.58	Facility		$5,210.58	$5,210.58	$5,210.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,210.58 / $5,210.58 / $6,130.09	Professional		$5,210.58	$5,210.58	$6,130.09
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $5,210.58 / $5,210.58 / $6,130.09	Professional		$5,210.58	$5,210.58	$6,130.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $50.00 / $60.00	Professional		$40.00	$50.00	$60.00
United Facility/Professional Professional Modifier Low / Median / High Price $5,108.41 / $5,108.41 / $6,339.54	Professional		$5,108.41	$5,108.41	$6,339.54