Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,248.07 / $5,248.07 / $8,511.38	Facility		$5,248.07	$5,248.07	$8,511.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,365.16 / $5,370.32 / $8,709.64	Professional		$4,365.16	$5,370.32	$8,709.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,964.78 / $11,481.54 / $23,442.29	Facility		$10,964.78	$11,481.54	$23,442.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,370.32 / $6,760.83 / $13,803.84	Professional		$5,370.32	$6,760.83	$13,803.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5,495.41 / $8,128.31 / $13,182.57	Facility		$5,495.41	$8,128.31	$13,182.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7,079.46 / $9,772.37 / $14,791.08	Professional		$7,079.46	$9,772.37	$14,791.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $7,585.78 / $7,585.78 / $7,585.78	Facility		$7,585.78	$7,585.78	$7,585.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,495.41 / $5,495.41 / $7,585.78	Professional		$5,495.41	$5,495.41	$7,585.78
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $7,585.78 / $7,585.78 / $7,585.78	Facility		$7,585.78	$7,585.78	$7,585.78
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $5,495.41 / $5,495.41 / $6,918.31	Professional		$5,495.41	$5,495.41	$6,918.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $6,025.60 / $9,332.54 / $13,803.84	Professional		$6,025.60	$9,332.54	$13,803.84
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $13,182.57 / $13,182.57 / $13,182.57	Facility		$13,182.57	$13,182.57	$13,182.57
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $10,964.78 / $12,302.69 / $22,387.21	Professional		$10,964.78	$12,302.69	$22,387.21
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $7,079.46 / $10,964.78	Facility		$4,265.80	$7,079.46	$10,964.78
United Facility/Professional Professional Modifier Low / Median / High Price $3,548.13 / $5,370.32 / $7,244.36	Professional		$3,548.13	$5,370.32	$7,244.36