Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,686.85 / $9,150.00 / $14,341.80	Facility		$4,686.85	$9,150.00	$14,341.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,686.85 / $4,733.72 / $10,686.00	Professional		$4,686.85	$4,733.72	$10,686.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,061.80 / $8,185.58 / $13,451.26	Facility		$5,061.80	$8,185.58	$13,451.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,686.85 / $4,686.85 / $7,902.02	Professional		$4,686.85	$4,686.85	$7,902.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,686.85 / $4,686.85 / $7,967.65	Facility		$4,686.85	$4,686.85	$7,967.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $4,686.85 / $4,686.85 / $6,327.25	Professional		$4,686.85	$4,686.85	$6,327.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,421.56 / $4,421.56 / $4,686.85	Facility		$4,421.56	$4,421.56	$4,686.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,686.85 / $4,686.85 / $7,032.61	Professional		$4,686.85	$4,686.85	$7,032.61
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $4,686.85 / $4,686.85 / $7,032.61	Professional		$4,686.85	$4,686.85	$7,032.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $5,155.53 / $5,859.57 / $6,795.93	Professional		$5,155.53	$5,859.57	$6,795.93
United Facility/Professional Professional Modifier Low / Median / High Price $4,686.85 / $4,686.85 / $6,519.88	Professional		$4,686.85	$4,686.85	$6,519.88