Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,475.20 / $3,931.89 / $9,551.74	Facility		$1,475.20	$3,931.89	$9,551.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,730.31 / $1,782.23 / $4,829.14	Professional		$1,730.31	$1,782.23	$4,829.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,868.75 / $2,785.82 / $4,931.41	Facility		$1,868.75	$2,785.82	$4,931.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,730.32 / $1,730.32 / $2,917.31	Professional		$1,730.32	$1,730.32	$2,917.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,730.32 / $1,737.10 / $2,600.78	Facility		$1,730.32	$1,737.10	$2,600.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,730.32 / $1,737.10 / $2,335.92	Professional		$1,730.32	$1,737.10	$2,335.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,632.38 / $1,632.38 / $1,730.32	Facility		$1,632.38	$1,632.38	$1,730.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,730.32 / $1,730.32 / $2,655.69	Professional		$1,730.32	$1,730.32	$2,655.69
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,632.38 / $1,966.52 / $3,785.98	Facility		$1,632.38	$1,966.52	$3,785.98
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,730.32 / $1,730.32 / $2,655.69	Professional		$1,730.32	$1,730.32	$2,655.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,903.35 / $2,171.37 / $2,508.96	Professional		$1,903.35	$2,171.37	$2,508.96
United Facility/Professional Professional Modifier Low / Median / High Price $1,730.32 / $1,853.17 / $2,118.83	Professional		$1,730.32	$1,853.17	$2,118.83