Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $4,073.80	Facility		$2,398.83	$2,398.83	$4,073.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,454.71 / $4,073.80	Professional		$2,089.30	$2,454.71	$4,073.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $5,370.32 / $10,715.19	Facility		$5,011.87	$5,370.32	$10,715.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $3,019.95 / $6,456.54	Professional		$2,454.71	$3,019.95	$6,456.54
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $4,168.69 / $4,168.69 / $4,168.69	Professional		$4,168.69	$4,168.69	$4,168.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $3,715.35 / $5,888.44	Facility		$2,454.71	$3,715.35	$5,888.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,235.94 / $4,466.84 / $6,760.83	Professional		$3,235.94	$4,466.84	$6,760.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $2,818.38 / $2,818.38	Facility		$2,818.38	$2,818.38	$2,818.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,041.74 / $2,818.38	Professional		$2,041.74	$2,041.74	$2,818.38
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $2,818.38 / $2,818.38	Facility		$2,818.38	$2,818.38	$2,818.38
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,041.74 / $2,818.38	Professional		$2,041.74	$2,041.74	$2,818.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $4,265.80 / $6,165.95	Professional		$2,691.53	$4,265.80	$6,165.95
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $6,025.60 / $6,025.60 / $6,025.60	Facility		$6,025.60	$6,025.60	$6,025.60
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $5,011.87 / $5,623.41 / $10,471.29	Professional		$5,011.87	$5,623.41	$10,471.29
United Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $3,311.31 / $5,128.61	Facility		$1,819.70	$3,311.31	$5,128.61
United Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,454.71 / $3,388.44	Professional		$1,659.59	$2,454.71	$3,388.44