Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $2,570.40 / $4,786.30	Facility		$2,570.40	$2,570.40	$4,786.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,691.53 / $4,365.16	Professional		$2,041.74	$2,691.53	$4,365.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,370.32 / $5,623.41 / $11,481.54	Facility		$5,370.32	$5,623.41	$11,481.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,467.37 / $4,786.30 / $8,317.64	Professional		$3,467.37	$4,786.30	$8,317.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $4,466.84 / $7,244.36	Facility		$3,019.95	$4,466.84	$7,244.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,890.45 / $5,370.32 / $8,128.31	Professional		$3,890.45	$5,370.32	$8,128.31
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 $2,951.21 / $4,570.88 / $6,760.83	Professional		$2,951.21	$4,570.88	$6,760.83
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $6,456.54 / $6,456.54 / $6,456.54	Facility		$6,456.54	$6,456.54	$6,456.54
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $5,370.32 / $6,025.60 / $10,964.78	Professional		$5,370.32	$6,025.60	$10,964.78
United Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $3,548.13 / $5,248.07	Facility		$1,862.09	$3,548.13	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,630.27 / $3,715.35	Professional		$1,737.80	$2,630.27	$3,715.35