Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,897.79 / $4,897.79 / $7,585.78	Facility		$4,897.79	$4,897.79	$7,585.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,467.37 / $4,897.79 / $6,760.83	Professional		$3,467.37	$4,897.79	$6,760.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,232.93 / $10,964.78 / $21,877.62	Facility		$10,232.93	$10,964.78	$21,877.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,897.79 / $6,025.60 / $13,182.57	Professional		$4,897.79	$6,025.60	$13,182.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,981.07 / $6,025.60 / $9,549.93	Facility		$3,981.07	$6,025.60	$9,549.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $5,248.07 / $7,244.36 / $10,715.19	Professional		$5,248.07	$7,244.36	$10,715.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,606.93 / $6,606.93 / $6,606.93	Facility		$6,606.93	$6,606.93	$6,606.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $6,606.93	Professional		$4,786.30	$4,786.30	$6,606.93
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $6,606.93 / $6,606.93 / $6,606.93	Facility		$6,606.93	$6,606.93	$6,606.93
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $6,165.95	Professional		$4,786.30	$4,786.30	$6,165.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $5,248.07 / $8,128.31 / $12,022.64	Professional		$5,248.07	$8,128.31	$12,022.64
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $12,302.69 / $12,302.69 / $12,302.69	Facility		$12,302.69	$12,302.69	$12,302.69
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $10,232.93 / $11,481.54 / $21,379.62	Professional		$10,232.93	$11,481.54	$21,379.62
United Facility/Professional Facility Modifier Low / Median / High Price $3,630.78 / $6,025.60 / $9,332.54	Facility		$3,630.78	$6,025.60	$9,332.54
United Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $4,897.79 / $6,456.54	Professional		$3,162.28	$4,897.79	$6,456.54