Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,728.23 / $1,728.23 / $3,680.00	Facility		$1,728.23	$1,728.23	$3,680.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,414.82 / $1,728.23 / $2,278.57	Professional		$1,414.82	$1,728.23	$2,278.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,323.52 / $3,893.36 / $10,087.35	Facility		$3,323.52	$3,893.36	$10,087.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,732.93 / $1,773.27 / $4,601.24	Professional		$1,732.93	$1,773.27	$4,601.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,300.62 / $3,539.42 / $4,778.22	Facility		$2,300.62	$3,539.42	$4,778.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,300.62 / $3,185.48 / $7,578.61	Professional		$2,300.62	$3,185.48	$7,578.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,289.62 / $2,289.62 / $3,837.70	Facility		$2,289.62	$2,289.62	$3,837.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,671.42 / $1,671.42 / $2,942.96	Professional		$1,671.42	$1,671.42	$2,942.96
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,289.62 / $2,289.62 / $2,289.62	Facility		$2,289.62	$2,289.62	$2,289.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,671.42 / $2,289.62 / $2,289.62	Professional		$1,671.42	$2,289.62	$2,289.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,835.16 / $2,523.34 / $3,308.10	Professional		$1,835.16	$2,523.34	$3,308.10
United Facility/Professional Professional Modifier Low / Median / High Price $1,177.18 / $1,765.78 / $2,246.69	Professional		$1,177.18	$1,765.78	$2,246.69