Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $3,548.13 / $5,888.44	Facility		$3,548.13	$3,548.13	$5,888.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,090.30 / $3,890.45 / $6,165.95	Professional		$3,090.30	$3,890.45	$6,165.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,413.10 / $7,762.47 / $15,848.93	Facility		$7,413.10	$7,762.47	$15,848.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,630.78 / $4,365.16 / $9,332.54	Professional		$3,630.78	$4,365.16	$9,332.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,466.84 / $6,760.83 / $10,715.19	Facility		$4,466.84	$6,760.83	$10,715.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $5,754.40 / $8,128.31 / $12,022.64	Professional		$5,754.40	$8,128.31	$12,022.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,677.35 / $4,677.35 / $4,677.35	Facility		$4,677.35	$4,677.35	$4,677.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,467.37 / $3,467.37 / $4,677.35	Professional		$3,467.37	$3,467.37	$4,677.35
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $4,677.35 / $4,677.35 / $4,677.35	Facility		$4,677.35	$4,677.35	$4,677.35
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $3,467.37 / $3,467.37 / $4,677.35	Professional		$3,467.37	$3,467.37	$4,677.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $4,073.80 / $6,456.54 / $9,332.54	Professional		$4,073.80	$6,456.54	$9,332.54
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $25.70 / $8,912.51	Facility		$25.70	$25.70	$8,912.51
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $7,413.10 / $8,317.64 / $15,135.61	Professional		$7,413.10	$8,317.64	$15,135.61
United Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $5,248.07 / $8,128.31	Facility		$2,951.21	$5,248.07	$8,128.31
United Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $3,630.78 / $5,370.32	Professional		$2,398.83	$3,630.78	$5,370.32