Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,913.65 / $10,879.90 / $48,576.00	Facility		$3,913.65	$10,879.90	$48,576.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,505.10 / $3,913.65 / $15,360.00	Professional		$3,505.10	$3,913.65	$15,360.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $0.02 / $0.03 / $0.07	Facility		$0.02	$0.03	$0.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16,000.00 / $16,960.00 / $27,252.76	Professional		$16,000.00	$16,960.00	$27,252.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,739.45 / $3,739.45 / $5,824.67	Facility		$3,739.45	$3,739.45	$5,824.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,739.45 / $3,739.45 / $3,739.45	Professional		$3,739.45	$3,739.45	$3,739.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16,320.00 / $16,960.00 / $16,960.00	Facility		$16,320.00	$16,960.00	$16,960.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16,320.00 / $16,960.00 / $19,200.00	Professional		$16,320.00	$16,960.00	$19,200.00
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $16,320.00 / $16,320.00 / $16,960.00	Facility		$16,320.00	$16,320.00	$16,960.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $16,320.00 / $16,960.00 / $16,960.00	Professional		$16,320.00	$16,960.00	$16,960.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $16,960.00 / $18,656.00 / $24,458.01	Professional		$16,960.00	$18,656.00	$24,458.01
United Facility/Professional Professional Modifier Low / Median / High Price $7,680.00 / $19,200.00 / $19,584.00	Professional		$7,680.00	$19,200.00	$19,584.00