Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,897.79 / $8,317.64 / $13,803.84	Facility		$4,897.79	$8,317.64	$13,803.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,897.79 / $5,011.87 / $6,456.54	Professional		$4,897.79	$5,011.87	$6,456.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,370.32 / $9,120.11 / $25,703.96	Facility		$5,370.32	$9,120.11	$25,703.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,897.79 / $5,370.32 / $8,709.64	Professional		$4,897.79	$5,370.32	$8,709.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility		$1,047.13	$1,047.13	$1,047.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,412.54	Professional		$1,412.54	$1,412.54	$1,412.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,677.35 / $4,677.35 / $4,897.79	Facility		$4,677.35	$4,677.35	$4,897.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $4,897.79 / $4,897.79	Professional		$2,137.96	$4,897.79	$4,897.79
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $4,677.35 / $4,677.35 / $4,897.79	Facility		$4,677.35	$4,677.35	$4,897.79
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $4,897.79 / $4,897.79	Professional		$2,137.96	$4,897.79	$4,897.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,513.56 / $6,918.31	Professional		$1,047.13	$1,513.56	$6,918.31
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,905.46 / $3,235.94	Professional		$1,412.54	$1,905.46	$3,235.94
United Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $4,897.79 / $4,897.79	Facility		$1,047.13	$4,897.79	$4,897.79
United Facility/Professional Professional Modifier Low / Median / High Price $4,786.30 / $4,897.79 / $5,248.07	Professional		$4,786.30	$4,897.79	$5,248.07