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 $4,168.69 / $4,897.79 / $7,585.78	Professional		$4,168.69	$4,897.79	$7,585.78
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 $5,128.61 / $6,025.60 / $13,182.57	Professional		$5,128.61	$6,025.60	$13,182.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,677.35 / $6,918.31 / $11,220.18	Facility		$4,677.35	$6,918.31	$11,220.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6,025.60 / $8,317.64 / $12,589.25	Professional		$6,025.60	$8,317.64	$12,589.25
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 / $6,309.57	Professional		$4,786.30	$4,786.30	$6,309.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $5,370.32 / $8,511.38 / $12,302.69	Professional		$5,370.32	$8,511.38	$12,302.69
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $25.70 / $12,302.69	Facility		$25.70	$25.70	$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 $3,981.07 / $6,760.83 / $10,471.29	Facility		$3,981.07	$6,760.83	$10,471.29
United Facility/Professional Professional Modifier Low / Median / High Price $3,388.44 / $5,011.87 / $6,918.31	Professional		$3,388.44	$5,011.87	$6,918.31