Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $4,168.69 / $6,918.31	Facility		$4,168.69	$4,168.69	$6,918.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,548.13 / $4,265.80 / $6,918.31	Professional		$3,548.13	$4,265.80	$6,918.31
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,709.64 / $9,332.54 / $18,620.87	Facility		$8,709.64	$9,332.54	$18,620.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,570.88 / $6,025.60 / $11,481.54	Professional		$4,570.88	$6,025.60	$11,481.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $6,309.57 / $10,000.00	Facility		$4,168.69	$6,309.57	$10,000.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $5,370.32 / $7,585.78 / $11,220.18	Professional		$5,370.32	$7,585.78	$11,220.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $4,786.30	Facility		$4,786.30	$4,786.30	$4,786.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,073.80 / $4,073.80 / $4,786.30	Professional		$4,073.80	$4,073.80	$4,786.30
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $4,786.30	Facility		$4,786.30	$4,786.30	$4,786.30
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $4,073.80 / $4,073.80 / $4,786.30	Professional		$4,073.80	$4,073.80	$4,786.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $4,466.84 / $6,309.57 / $9,120.11	Professional		$4,466.84	$6,309.57	$9,120.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $10,471.29 / $10,471.29 / $10,471.29	Facility		$10,471.29	$10,471.29	$10,471.29
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $8,709.64 / $9,772.37 / $18,197.01	Professional		$8,709.64	$9,772.37	$18,197.01
United Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $5,754.40 / $8,709.64	Facility		$3,162.28	$5,754.40	$8,709.64
United Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $4,265.80 / $6,025.60	Professional		$2,884.03	$4,265.80	$6,025.60