Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,855.86 / $10,459.00 / $13,736.50	Facility		$3,855.86	$10,459.00	$13,736.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,855.86 / $3,904.05 / $4,935.50	Professional		$3,855.86	$3,904.05	$4,935.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $0.02 / $0.02 / $0.07	Facility		$0.02	$0.02	$0.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,819.82 / $5,542.79 / $7,952.70	Professional		$4,819.82	$5,542.79	$7,952.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6,506.76 / $6,906.06 / $11,061.49	Facility		$6,506.76	$6,906.06	$11,061.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $4,819.82 / $6,506.76 / $6,506.76	Professional		$4,819.82	$6,506.76	$6,506.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,819.82 / $4,819.82 / $4,819.82	Facility		$4,819.82	$4,819.82	$4,819.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,819.82 / $4,819.82 / $6,138.45	Professional		$4,819.82	$4,819.82	$6,138.45
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $4,819.82 / $4,819.82 / $4,819.82	Facility		$4,819.82	$4,819.82	$4,819.82
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $4,819.82 / $4,819.82 / $6,820.50	Professional		$4,819.82	$4,819.82	$6,820.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $4,819.82 / $5,542.79 / $6,950.66	Professional		$4,819.82	$5,542.79	$6,950.66
United Facility/Professional Professional Modifier Low / Median / High Price $5,673.20 / $5,684.00 / $6,877.64	Professional		$5,673.20	$5,684.00	$6,877.64