Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,700.78 / $2,700.78 / $9,865.00	Facility		$2,700.78	$2,700.78	$9,865.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,416.39 / $2,700.78 / $3,363.56	Professional		$2,416.39	$2,700.78	$3,363.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,193.80 / $6,084.32 / $15,763.92	Facility		$5,193.80	$6,084.32	$15,763.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,771.15 / $2,952.48 / $7,190.56	Professional		$2,771.15	$2,952.48	$7,190.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,822.96 / $5,531.20 / $7,467.12	Facility		$3,822.96	$5,531.20	$7,467.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,595.28 / $4,978.08 / $11,843.41	Professional		$3,595.28	$4,978.08	$11,843.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,578.08 / $3,578.08 / $6,353.15	Facility		$3,578.08	$3,578.08	$6,353.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,612.00 / $2,612.00 / $4,599.09	Professional		$2,612.00	$2,612.00	$4,599.09
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $3,578.08 / $3,578.08 / $3,578.08	Facility		$3,578.08	$3,578.08	$3,578.08
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $2,612.00 / $3,578.08 / $3,578.08	Professional		$2,612.00	$3,578.08	$3,578.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,346.41 / $3,226.32 / $4,229.70	Professional		$2,346.41	$3,226.32	$4,229.70
United Facility/Professional Professional Modifier Low / Median / High Price $1,839.64 / $2,759.45 / $3,715.30	Professional		$1,839.64	$2,759.45	$3,715.30