Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $2,511.89 / $4,265.80	Facility		$2,511.89	$2,511.89	$4,265.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $2,511.89 / $4,168.69	Professional		$2,137.96	$2,511.89	$4,168.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,248.07 / $5,495.41 / $11,220.18	Facility		$5,248.07	$5,495.41	$11,220.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $2,884.03 / $6,606.93	Professional		$2,511.89	$2,884.03	$6,606.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $3,801.89 / $6,165.95	Facility		$2,570.40	$3,801.89	$6,165.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,311.31 / $4,570.88 / $6,918.31	Professional		$3,311.31	$4,570.88	$6,918.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $3,311.31 / $3,311.31	Facility		$3,311.31	$3,311.31	$3,311.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $3,311.31	Professional		$2,398.83	$2,398.83	$3,311.31
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $3,311.31 / $3,311.31	Facility		$3,311.31	$3,311.31	$3,311.31
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $3,311.31	Professional		$2,398.83	$2,398.83	$3,311.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $4,365.16 / $6,309.57	Professional		$2,754.23	$4,365.16	$6,309.57
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $6,165.95 / $6,165.95 / $6,165.95	Facility		$6,165.95	$6,165.95	$6,165.95
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $5,248.07 / $5,754.40 / $10,715.19	Professional		$5,248.07	$5,754.40	$10,715.19
United Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $3,388.44 / $5,248.07	Facility		$1,905.46	$3,388.44	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,511.89 / $3,467.37	Professional		$1,698.24	$2,511.89	$3,467.37