Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,698.05 / $5,854.77 / $8,390.94	Facility		$2,698.05	$5,854.77	$8,390.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,698.05 / $3,479.13	Professional		$2,698.05	$2,698.05	$3,479.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,913.89 / $4,627.16 / $7,689.44	Facility		$2,913.89	$4,627.16	$7,689.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $3,043.40 / $4,548.91	Professional		$2,698.05	$3,043.40	$4,548.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,698.05 / $2,698.05 / $4,055.54	Facility		$2,698.05	$2,698.05	$4,055.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,698.05 / $3,642.37	Professional		$2,698.05	$2,698.05	$3,642.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,545.33 / $2,658.13 / $2,698.05	Facility		$2,545.33	$2,658.13	$2,698.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,698.05 / $3,436.20	Professional		$2,698.05	$2,698.05	$3,436.20
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,545.33 / $2,658.13 / $3,428.99	Facility		$2,545.33	$2,658.13	$3,428.99
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,698.05 / $3,818.00	Professional		$2,698.05	$2,698.05	$3,818.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,658.13 / $3,056.84 / $3,833.28	Professional		$2,658.13	$3,056.84	$3,833.28
United Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,698.05 / $3,188.47	Professional		$2,698.05	$2,698.05	$3,188.47