Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43,651.58 / $89,125.09 / $147,910.84	Facility		$43,651.58	$89,125.09	$147,910.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43,651.58 / $43,651.58 / $58,884.37	Professional		$43,651.58	$43,651.58	$58,884.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $46,773.51 / $69,183.10 / $154,881.66	Facility		$46,773.51	$69,183.10	$154,881.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43,651.58 / $47,863.01 / $74,131.02	Professional		$43,651.58	$47,863.01	$74,131.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $44,668.36 / $44,668.36 / $44,668.36	Facility		$44,668.36	$44,668.36	$44,668.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $44,668.36 / $44,668.36 / $60,255.96	Professional		$44,668.36	$44,668.36	$60,255.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40,738.03 / $40,738.03 / $67,608.30	Facility		$40,738.03	$40,738.03	$67,608.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43,651.58 / $43,651.58 / $60,255.96	Professional		$43,651.58	$43,651.58	$60,255.96
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $40,738.03 / $43,651.58 / $60,255.96	Facility		$40,738.03	$43,651.58	$60,255.96
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $43,651.58 / $43,651.58 / $61,659.50	Professional		$43,651.58	$43,651.58	$61,659.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $43,651.58 / $48,977.88 / $63,095.73	Professional		$43,651.58	$48,977.88	$63,095.73
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $38,904.51 / $45,708.82 / $79,432.82	Professional		$38,904.51	$45,708.82	$79,432.82
United Facility/Professional Facility Modifier Low / Median / High Price $43,651.58 / $43,651.58 / $44,668.36	Facility		$43,651.58	$43,651.58	$44,668.36
United Facility/Professional Professional Modifier Low / Median / High Price $40,738.03 / $44,668.36 / $50,118.72	Professional		$40,738.03	$44,668.36	$50,118.72