Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,016.42 / $4,375.63 / $6,170.25	Facility		$2,016.42	$4,375.63	$6,170.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,016.42 / $2,016.42 / $4,506.53	Professional		$2,016.42	$2,016.42	$4,506.53
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,177.73 / $3,521.68 / $5,787.13	Facility		$2,177.73	$3,521.68	$5,787.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,016.42 / $2,016.42 / $3,399.68	Professional		$2,016.42	$2,016.42	$3,399.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,016.42 / $2,016.42 / $3,427.91	Facility		$2,016.42	$2,016.42	$3,427.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,016.42 / $2,016.42 / $2,722.17	Professional		$2,016.42	$2,016.42	$2,722.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,902.29 / $1,902.29 / $2,016.42	Facility		$1,902.29	$1,902.29	$2,016.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,016.42 / $2,016.42 / $3,236.18	Professional		$2,016.42	$2,016.42	$3,236.18
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $2,016.42 / $2,016.42 / $3,236.18	Professional		$2,016.42	$2,016.42	$3,236.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,174.20 / $2,520.52 / $2,865.99	Professional		$2,174.20	$2,520.52	$2,865.99
United Facility/Professional Facility Modifier Low / Median / High Price $2,016.42 / $2,016.42 / $2,016.42	Facility		$2,016.42	$2,016.42	$2,016.42
United Facility/Professional Professional Modifier Low / Median / High Price $2,016.42 / $2,016.42 / $2,286.73	Professional		$2,016.42	$2,016.42	$2,286.73