Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $7,413.10	Facility		$4,786.30	$4,786.30	$7,413.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,467.37 / $4,786.30 / $6,760.83	Professional		$3,467.37	$4,786.30	$6,760.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,000.00 / $10,471.29 / $21,379.62	Facility		$10,000.00	$10,471.29	$21,379.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,897.79 / $5,754.40 / $12,589.25	Professional		$4,897.79	$5,754.40	$12,589.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,073.80 / $6,025.60 / $9,772.37	Facility		$4,073.80	$6,025.60	$9,772.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $5,248.07 / $7,244.36 / $10,964.78	Professional		$5,248.07	$7,244.36	$10,964.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,309.57 / $6,309.57 / $6,309.57	Facility		$6,309.57	$6,309.57	$6,309.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,570.88 / $4,570.88 / $6,309.57	Professional		$4,570.88	$4,570.88	$6,309.57
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $6,309.57 / $6,309.57 / $6,309.57	Facility		$6,309.57	$6,309.57	$6,309.57
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $4,570.88 / $4,570.88 / $5,888.44	Professional		$4,570.88	$4,570.88	$5,888.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $5,623.41 / $8,912.51 / $12,882.50	Professional		$5,623.41	$8,912.51	$12,882.50
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $12,022.64 / $12,022.64 / $12,022.64	Facility		$12,022.64	$12,022.64	$12,022.64
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $10,000.00 / $11,220.18 / $20,417.38	Professional		$10,000.00	$11,220.18	$20,417.38
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 / $4,786.30 / $6,165.95	Professional		$3,162.28	$4,786.30	$6,165.95