Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,630.78 / $6,606.93 / $9,332.54	Facility		$3,630.78	$6,606.93	$9,332.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $3,162.28 / $4,677.35	Professional		$2,344.23	$3,162.28	$4,677.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $4,073.80 / $7,079.46	Facility		$3,548.13	$4,073.80	$7,079.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,000.00 / $4,786.30	Professional		$794.33	$1,000.00	$4,786.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,630.78 / $41,686.94 / $81,283.05	Facility		$3,630.78	$41,686.94	$81,283.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $4,786.30 / $60,255.96 / $107,151.93	Professional		$4,786.30	$60,255.96	$107,151.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $2,511.89 / $13,182.57	Facility		$2,511.89	$2,511.89	$13,182.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $4,466.84 / $4,897.79	Professional		$2,290.87	$4,466.84	$4,897.79
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $3,981.07 / $15,848.93	Facility		$2,570.40	$3,981.07	$15,848.93
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $2,290.87 / $2,290.87	Professional		$2,290.87	$2,290.87	$2,290.87
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $4,677.35 / $4,677.35 / $4,677.35	Facility		$4,677.35	$4,677.35	$4,677.35
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $3,311.31 / $4,265.80 / $8,912.51	Professional		$3,311.31	$4,265.80	$8,912.51
United Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $3,467.37 / $3,890.45	Facility		$1,380.38	$3,467.37	$3,890.45
United Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,344.23 / $4,466.84	Professional		$1,621.81	$2,344.23	$4,466.84