Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,840.83 / $1,840.83 / $4,593.00	Facility		$1,840.83	$1,840.83	$4,593.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,794.18 / $1,840.83 / $2,535.23	Professional		$1,794.18	$1,840.83	$2,535.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,540.05 / $4,147.02 / $10,744.56	Facility		$3,540.05	$4,147.02	$10,744.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,888.80 / $2,060.88 / $4,901.02	Professional		$1,888.80	$2,060.88	$4,901.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,827.52 / $3,770.02 / $5,089.53	Facility		$2,827.52	$3,770.02	$5,089.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,463.77 / $3,411.37 / $8,072.37	Professional		$2,463.77	$3,411.37	$8,072.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,677.88 / $2,677.88 / $4,441.88	Facility		$2,677.88	$2,677.88	$4,441.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,954.85 / $1,954.85 / $2,677.88	Professional		$1,954.85	$1,954.85	$2,677.88
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,677.88 / $2,677.88 / $2,677.88	Facility		$2,677.88	$2,677.88	$2,677.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,954.85 / $2,677.88 / $2,677.88	Professional		$1,954.85	$2,677.88	$2,677.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,599.29 / $2,199.03 / $2,882.93	Professional		$1,599.29	$2,199.03	$2,882.93
United Facility/Professional Professional Modifier Low / Median / High Price $1,253.88 / $1,880.82 / $2,605.35	Professional		$1,253.88	$1,880.82	$2,605.35