Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,828.72 / $3,968.32 / $6,089.64	Facility		$1,828.72	$3,968.32	$6,089.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,828.72 / $1,879.74 / $5,173.93	Professional		$1,828.72	$1,879.74	$5,173.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,975.01 / $3,193.84 / $5,449.59	Facility		$1,975.01	$3,193.84	$5,449.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,828.72 / $1,828.72 / $3,474.56	Professional		$1,828.72	$1,828.72	$3,474.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,828.72 / $1,828.72 / $3,108.82	Facility		$1,828.72	$1,828.72	$3,108.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,828.72 / $1,828.72 / $2,468.77	Professional		$1,828.72	$1,828.72	$2,468.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,725.20 / $1,725.20 / $1,828.71	Facility		$1,725.20	$1,725.20	$1,828.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,828.71 / $1,828.71 / $5,132.27	Professional		$1,828.71	$1,828.71	$5,132.27
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,725.20 / $1,725.20 / $1,828.71	Facility		$1,725.20	$1,725.20	$1,828.71
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,828.71 / $1,828.71 / $5,132.27	Professional		$1,828.71	$1,828.71	$5,132.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,011.59 / $2,326.41 / $2,651.64	Professional		$2,011.59	$2,326.41	$2,651.64
United Facility/Professional Professional Modifier Low / Median / High Price $1,828.72 / $1,828.72 / $2,380.98	Professional		$1,828.72	$1,828.72	$2,380.98