Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,105.90 / $2,105.90 / $5,267.00	Facility		$2,105.90	$2,105.90	$5,267.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,934.37 / $2,105.90 / $2,665.88	Professional		$1,934.37	$2,105.90	$2,665.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,049.78 / $4,744.16 / $12,291.68	Facility		$4,049.78	$4,744.16	$12,291.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,103.94 / $2,369.29 / $5,606.73	Professional		$2,103.94	$2,369.29	$5,606.73
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $3,665.94 / $3,665.94 / $3,665.94	Professional		$3,665.94	$3,665.94	$3,665.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,234.65 / $4,312.87 / $5,822.37	Facility		$3,234.65	$4,312.87	$5,822.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,019.01 / $4,307.07 / $9,234.71	Professional		$3,019.01	$4,307.07	$9,234.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,481.10 / $2,481.10 / $5,608.16	Facility		$2,481.10	$2,481.10	$5,608.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,811.20 / $1,811.20 / $3,169.61	Professional		$1,811.20	$1,811.20	$3,169.61
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,481.10 / $2,481.10 / $2,481.10	Facility		$2,481.10	$2,481.10	$2,481.10
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,811.20 / $2,481.10 / $2,481.10	Professional		$1,811.20	$2,481.10	$2,481.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,331.67 / $3,206.04 / $4,203.13	Professional		$2,331.67	$3,206.04	$4,203.13
United Facility/Professional Facility Modifier Low / Median / High Price $1,778.74 / $2,961.61 / $3,450.30	Facility		$1,778.74	$2,961.61	$3,450.30
United Facility/Professional Professional Modifier Low / Median / High Price $1,434.43 / $2,151.64 / $3,032.69	Professional		$1,434.43	$2,151.64	$3,032.69