Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,883.95 / $6,251.00 / $11,581.00	Facility		$1,883.95	$6,251.00	$11,581.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,095.45 / $1,266.95 / $2,336.91	Professional		$1,095.45	$1,266.95	$2,336.91
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,315.00 / $16,655.00 / $29,882.70	Facility		$3,315.00	$16,655.00	$29,882.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,008.10 / $1,366.56 / $2,181.07	Professional		$1,008.10	$1,366.56	$2,181.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,160.57 / $1,266.07 / $1,843.58	Facility		$1,160.57	$1,266.07	$1,843.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,281.25 / $1,365.38 / $1,737.75	Professional		$1,281.25	$1,365.38	$1,737.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,571.00 / $21,571.00 / $21,571.00	Facility		$21,571.00	$21,571.00	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,238.09 / $1,737.75 / $2,450.12	Professional		$1,238.09	$1,737.75	$2,450.12
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,480.64 / $1,480.64 / $1,480.64	Facility		$1,480.64	$1,480.64	$1,480.64
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,238.09 / $1,775.43 / $2,450.12	Professional		$1,238.09	$1,775.43	$2,450.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $144.74 / $906.08 / $1,561.33	Professional		$144.74	$906.08	$1,561.33
United Facility/Professional Facility Modifier Low / Median / High Price $4,070.00 / $8,440.00 / $13,382.00	Facility		$4,070.00	$8,440.00	$13,382.00
United Facility/Professional Professional Modifier Low / Median / High Price $976.23 / $1,523.81 / $2,488.83	Professional		$976.23	$1,523.81	$2,488.83