Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $3,311.31 / $5,888.44	Facility		$3,311.31	$3,311.31	$5,888.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $3,311.31 / $5,248.07	Professional		$2,691.53	$3,311.31	$5,248.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,918.31 / $7,244.36 / $14,791.08	Facility		$6,918.31	$7,244.36	$14,791.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,388.44 / $4,073.80 / $8,709.64	Professional		$3,388.44	$4,073.80	$8,709.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $4,677.35 / $7,413.10	Facility		$3,090.30	$4,677.35	$7,413.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $4,073.80 / $5,623.41 / $8,317.64	Professional		$4,073.80	$5,623.41	$8,317.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,365.16 / $4,365.16 / $4,365.16	Facility		$4,365.16	$4,365.16	$4,365.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $3,162.28 / $4,365.16	Professional		$3,162.28	$3,162.28	$4,365.16
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $4,365.16 / $4,365.16 / $4,365.16	Facility		$4,365.16	$4,365.16	$4,365.16
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $3,162.28 / $4,168.69	Professional		$3,162.28	$3,162.28	$4,168.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $4,073.80 / $5,888.44	Professional		$2,951.21	$4,073.80	$5,888.44
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $8,317.64 / $8,317.64 / $8,317.64	Facility		$8,317.64	$8,317.64	$8,317.64
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $6,918.31 / $7,762.47 / $14,125.38	Professional		$6,918.31	$7,762.47	$14,125.38
United Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,677.35 / $7,244.36	Facility		$2,818.38	$4,677.35	$7,244.36
United Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $3,311.31 / $4,786.30	Professional		$2,238.72	$3,311.31	$4,786.30