Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,754.40 / $12,302.69 / $18,197.01	Facility		$5,754.40	$12,302.69	$18,197.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $5,754.40 / $6,025.60 / $7,413.10	Professional		$5,754.40	$6,025.60	$7,413.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $8,317.64 / $42,657.95	Facility		$3,311.31	$8,317.64	$42,657.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,691.53 / $6,606.93	Professional		$2,089.30	$2,691.53	$6,606.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $660.69 / $794.33	Facility		$562.34	$660.69	$794.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $724.44	Professional		$660.69	$660.69	$724.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $6,165.95 / $11,748.98	Facility		$3,311.31	$6,165.95	$11,748.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $6,165.95 / $6,165.95 / $7,244.36	Professional		$6,165.95	$6,165.95	$7,244.36
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $5,248.07 / $6,165.95 / $6,918.31	Facility		$5,248.07	$6,165.95	$6,918.31
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $6,165.95 / $6,165.95 / $7,244.36	Professional		$6,165.95	$6,165.95	$7,244.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,344.23 / $3,090.30	Professional		$2,089.30	$2,344.23	$3,090.30
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $3,981.07 / $3,981.07 / $3,981.07	Facility		$3,981.07	$3,981.07	$3,981.07
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $7,079.46 / $8,709.64 / $16,218.10	Professional		$7,079.46	$8,709.64	$16,218.10
United Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $3,311.31 / $5,248.07	Facility		$3,311.31	$3,311.31	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $5,888.44 / $6,606.93 / $7,413.10	Professional		$5,888.44	$6,606.93	$7,413.10