Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,128.02 / $8,654.68 / $13,016.00	Facility		$4,128.02	$8,654.68	$13,016.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,125.55 / $4,128.02 / $5,234.08	Professional		$4,125.55	$4,128.02	$5,234.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,458.26 / $7,079.55 / $11,764.86	Facility		$4,458.26	$7,079.55	$11,764.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,128.02 / $4,623.38 / $6,873.15	Professional		$4,128.02	$4,623.38	$6,873.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,128.02 / $4,128.02 / $6,205.09	Facility		$4,128.02	$4,128.02	$6,205.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $4,128.02 / $4,128.02 / $4,747.22	Professional		$4,128.02	$4,128.02	$4,747.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,894.36 / $3,989.64 / $4,128.02	Facility		$3,894.36	$3,989.64	$4,128.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,128.02 / $4,128.02 / $4,891.35	Professional		$4,128.02	$4,128.02	$4,891.35
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $3,894.36 / $4,128.02 / $5,745.08	Facility		$3,894.36	$4,128.02	$5,745.08
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $4,128.02 / $4,128.02 / $5,841.54	Professional		$4,128.02	$4,128.02	$5,841.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $4,125.55 / $4,744.38 / $5,783.07	Professional		$4,125.55	$4,744.38	$5,783.07
United Facility/Professional Professional Modifier Low / Median / High Price $4,120.18 / $4,128.02 / $4,871.06	Professional		$4,120.18	$4,128.02	$4,871.06