Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,478.83 / $1,478.83 / $3,108.00	Facility		$1,478.83	$1,478.83	$3,108.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,166.34 / $1,478.83 / $1,729.62	Professional		$1,166.34	$1,478.83	$1,729.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,843.88 / $3,331.49 / $8,631.60	Facility		$2,843.88	$3,331.49	$8,631.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,428.58 / $1,556.88 / $3,937.21	Professional		$1,428.58	$1,556.88	$3,937.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,968.61 / $3,028.63 / $4,088.65	Facility		$1,968.61	$3,028.63	$4,088.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,968.61 / $2,725.77 / $6,484.90	Professional		$1,968.61	$2,725.77	$6,484.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,486.28 / $1,486.28 / $3,070.14	Facility		$1,486.28	$1,486.28	$3,070.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,084.98 / $1,084.98 / $1,898.72	Professional		$1,084.98	$1,084.98	$1,898.72
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,486.28 / $1,486.28 / $1,486.28	Facility		$1,486.28	$1,486.28	$1,486.28
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,084.98 / $1,486.28 / $1,486.28	Professional		$1,084.98	$1,486.28	$1,486.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,637.37 / $2,251.39 / $2,951.57	Professional		$1,637.37	$2,251.39	$2,951.57
United Facility/Professional Facility Modifier Low / Median / High Price $1,428.89 / $1,428.89 / $1,428.89	Facility		$1,428.89	$1,428.89	$1,428.89
United Facility/Professional Professional Modifier Low / Median / High Price $988.88 / $1,510.95 / $1,934.63	Professional		$988.88	$1,510.95	$1,934.63