Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,116.32 / $4,142.49 / $6,070.01	Facility		$2,116.32	$4,142.49	$6,070.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,116.32 / $2,246.00 / $4,067.00	Professional		$2,116.32	$2,246.00	$4,067.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,285.63 / $3,696.15 / $6,073.84	Facility		$2,285.63	$3,696.15	$6,073.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,116.32 / $2,116.32 / $3,568.11	Professional		$2,116.32	$2,116.32	$3,568.11
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $2,835.87 / $2,835.87 / $2,835.87	Facility		$2,835.87	$2,835.87	$2,835.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,116.32 / $2,116.32 / $3,597.74	Facility		$2,116.32	$2,116.32	$3,597.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,116.32 / $2,116.32 / $2,857.03	Professional		$2,116.32	$2,116.32	$2,857.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,996.53 / $1,996.53 / $2,116.32	Facility		$1,996.53	$1,996.53	$2,116.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,116.32 / $2,116.32 / $3,173.15	Professional		$2,116.32	$2,116.32	$3,173.15
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $3,044.85 / $3,972.26 / $6,874.16	Facility		$3,044.85	$3,972.26	$6,874.16
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $2,116.32 / $2,116.32 / $5,425.03	Professional		$2,116.32	$2,116.32	$5,425.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,324.56 / $2,645.40 / $3,064.19	Professional		$2,324.56	$2,645.40	$3,064.19
United Facility/Professional Professional Modifier Low / Median / High Price $2,116.32 / $2,116.32 / $2,289.01	Professional		$2,116.32	$2,116.32	$2,289.01