Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $6,309.57 / $6,309.57 / $10,964.78	Facility		$6,309.57	$6,309.57	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,786.30 / $6,309.57 / $8,912.51	Professional		$4,786.30	$6,309.57	$8,912.51
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $13,182.57 / $13,803.84 / $28,183.83	Facility		$13,182.57	$13,803.84	$28,183.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $6,456.54 / $7,585.78 / $16,595.87	Professional		$6,456.54	$7,585.78	$16,595.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5,248.07 / $7,943.28 / $12,882.50	Facility		$5,248.07	$7,943.28	$12,882.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6,918.31 / $9,549.93 / $14,454.40	Professional		$6,918.31	$9,549.93	$14,454.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8,317.64 / $8,317.64 / $8,317.64	Facility		$8,317.64	$8,317.64	$8,317.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $6,025.60 / $6,025.60 / $8,317.64	Professional		$6,025.60	$6,025.60	$8,317.64
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $8,317.64 / $8,317.64 / $8,317.64	Facility		$8,317.64	$8,317.64	$8,317.64
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $6,025.60 / $6,025.60 / $7,413.10	Professional		$6,025.60	$6,025.60	$7,413.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $5,888.44 / $9,332.54 / $13,489.63	Professional		$5,888.44	$9,332.54	$13,489.63
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $25.70 / $15,848.93	Facility		$25.70	$25.70	$15,848.93
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $13,182.57 / $14,791.08 / $26,915.35	Professional		$13,182.57	$14,791.08	$26,915.35
United Facility/Professional Facility Modifier Low / Median / High Price $4,365.16 / $7,943.28 / $12,302.69	Facility		$4,365.16	$7,943.28	$12,302.69
United Facility/Professional Professional Modifier Low / Median / High Price $4,265.80 / $6,309.57 / $8,128.31	Professional		$4,265.80	$6,309.57	$8,128.31