Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,874.10 / $1,874.10 / $4,193.00	Facility		$1,874.10	$1,874.10	$4,193.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,623.36 / $1,874.10 / $2,473.32	Professional		$1,623.36	$1,874.10	$2,473.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,604.02 / $4,221.97 / $10,938.73	Facility		$3,604.02	$4,221.97	$10,938.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,922.93 / $1,988.34 / $4,989.59	Professional		$1,922.93	$1,988.34	$4,989.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,494.80 / $3,838.15 / $5,181.50	Facility		$2,494.80	$3,838.15	$5,181.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,494.80 / $3,454.34 / $8,218.25	Professional		$2,494.80	$3,454.34	$8,218.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,482.86 / $2,482.86 / $4,343.18	Facility		$2,482.86	$2,482.86	$4,343.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,812.49 / $1,812.49 / $3,171.85	Professional		$1,812.49	$1,812.49	$3,171.85
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,482.86 / $2,482.86 / $2,482.86	Facility		$2,482.86	$2,482.86	$2,482.86
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,812.49 / $2,482.86 / $2,482.86	Professional		$1,812.49	$2,482.86	$2,482.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,628.19 / $2,238.76 / $2,935.01	Professional		$1,628.19	$2,238.76	$2,935.01
United Facility/Professional Facility Modifier Low / Median / High Price $1,492.75 / $2,485.42 / $3,070.52	Facility		$1,492.75	$2,485.42	$3,070.52
United Facility/Professional Professional Modifier Low / Median / High Price $1,276.54 / $1,914.82 / $2,545.08	Professional		$1,276.54	$1,914.82	$2,545.08