Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,864.00 / $3,864.00 / $3,864.00	Facility		$3,864.00	$3,864.00	$3,864.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,864.00 / $3,864.00 / $4,105.50	Professional		$3,864.00	$3,864.00	$4,105.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,968.00 / $3,413.20 / $4,906.10	Professional		$2,968.00	$3,413.20	$4,906.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,006.80 / $4,006.80 / $6,811.56	Facility		$4,006.80	$4,006.80	$6,811.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,968.00 / $4,006.80 / $4,006.80	Professional		$2,968.00	$4,006.80	$4,006.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,105.50 / $4,105.50 / $4,105.50	Facility		$4,105.50	$4,105.50	$4,105.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,105.50 / $4,105.50 / $4,105.50	Professional		$4,105.50	$4,105.50	$4,105.50
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $4,105.50 / $4,105.50 / $4,105.50	Facility		$4,105.50	$4,105.50	$4,105.50
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $4,105.50 / $4,105.50 / $4,830.00	Professional		$4,105.50	$4,105.50	$4,830.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,264.80 / $3,264.80 / $4,897.20	Professional		$3,264.80	$3,264.80	$4,897.20
United Facility/Professional Professional Modifier Low / Median / High Price $4,200.00 / $4,200.00 / $5,212.20	Professional		$4,200.00	$4,200.00	$5,212.20