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 / $8,128.31	Facility		$4,897.79	$4,897.79	$8,128.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,265.80 / $5,011.87 / $8,128.31	Professional		$4,265.80	$5,011.87	$8,128.31
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 $4,897.79 / $6,606.93 / $13,182.57	Professional		$4,897.79	$6,606.93	$13,182.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,897.79 / $7,413.10 / $11,748.98	Facility		$4,897.79	$7,413.10	$11,748.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6,456.54 / $8,912.51 / $13,182.57	Professional		$6,456.54	$8,912.51	$13,182.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $7,943.28 / $7,943.28 / $7,943.28	Facility		$7,943.28	$7,943.28	$7,943.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $6,760.83 / $6,760.83 / $7,943.28	Professional		$6,760.83	$6,760.83	$7,943.28
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $7,943.28 / $7,943.28 / $7,943.28	Facility		$7,943.28	$7,943.28	$7,943.28
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $6,760.83 / $6,760.83 / $6,760.83	Professional		$6,760.83	$6,760.83	$6,760.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $5,248.07 / $7,413.10 / $10,715.19	Professional		$5,248.07	$7,413.10	$10,715.19
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $12,302.69 / $12,302.69 / $12,302.69	Facility		$12,302.69	$12,302.69	$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 $3,715.35 / $6,760.83 / $10,232.93	Facility		$3,715.35	$6,760.83	$10,232.93
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