Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,622.00 / $6,492.00 / $11,581.00	Facility		$1,622.00	$6,492.00	$11,581.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $582.54 / $891.02 / $995.11	Professional		$582.54	$891.02	$995.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $918.00 / $2,114.00 / $8,800.00	Facility		$918.00	$2,114.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $244.38 / $878.31 / $1,175.14	Professional		$244.38	$878.31	$1,175.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $865.50 / $2,295.31 / $20,252.70	Facility		$865.50	$2,295.31	$20,252.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $865.50 / $12,982.50 / $22,394.82	Professional		$865.50	$12,982.50	$22,394.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $530.00 / $1,042.24 / $1,758.30	Facility		$530.00	$1,042.24	$1,758.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,459.62 / $4,328.07 / $4,328.07	Professional		$1,459.62	$4,328.07	$4,328.07
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $530.00 / $1,042.24 / $1,309.85	Facility		$530.00	$1,042.24	$1,309.85
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,459.62 / $1,459.62 / $4,328.07	Professional		$1,459.62	$1,459.62	$4,328.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $60.00 / $60.00	Professional		$30.00	$60.00	$60.00
United Facility/Professional Facility Modifier Low / Median / High Price $675.00 / $2,499.00 / $5,235.00	Facility		$675.00	$2,499.00	$5,235.00
United Facility/Professional Professional Modifier Low / Median / High Price $801.92 / $1,136.82 / $1,860.49	Professional		$801.92	$1,136.82	$1,860.49