Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,168.22 / $10,181.40 / $15,452.30	Facility		$5,168.22	$10,181.40	$15,452.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $5,018.27 / $5,191.93 / $11,783.60	Professional		$5,018.27	$5,191.93	$11,783.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,581.69 / $9,026.31 / $14,832.82	Facility		$5,581.69	$9,026.31	$14,832.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,168.22 / $5,168.22 / $8,713.62	Professional		$5,168.22	$5,168.22	$8,713.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5,168.22 / $5,168.22 / $8,785.99	Facility		$5,168.22	$5,168.22	$8,785.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $5,168.22 / $5,168.22 / $6,977.11	Professional		$5,168.22	$5,168.22	$6,977.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,875.68 / $4,875.68 / $5,168.22	Facility		$4,875.68	$4,875.68	$5,168.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,168.22 / $5,168.22 / $7,675.93	Professional		$5,168.22	$5,168.22	$7,675.93
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $5,168.22 / $5,168.22 / $7,675.93	Professional		$5,168.22	$5,168.22	$7,675.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $5,465.43 / $6,460.28 / $7,493.93	Professional		$5,465.43	$6,460.28	$7,493.93
United Facility/Professional Professional Modifier Low / Median / High Price $5,168.22 / $5,168.22 / $6,729.04	Professional		$5,168.22	$5,168.22	$6,729.04