Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,268.74 / $5,653.00 / $10,635.00	Facility		$1,268.74	$5,653.00	$10,635.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $739.77 / $870.56 / $1,703.34	Professional		$739.77	$870.56	$1,703.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,097.00 / $8,088.00 / $36,529.00	Facility		$2,097.00	$8,088.00	$36,529.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $701.47 / $923.54 / $1,461.91	Professional		$701.47	$923.54	$1,461.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $781.13 / $1,002.52 / $1,331.46	Facility		$781.13	$1,002.52	$1,331.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $918.97 / $1,169.59 / $127,498.73	Professional		$918.97	$1,169.59	$127,498.73
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 $863.84 / $1,169.59 / $1,640.64	Professional		$863.84	$1,169.59	$1,640.64
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $998.04 / $998.04 / $998.04	Facility		$998.04	$998.04	$998.04
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $877.20 / $1,193.46 / $1,604.06	Professional		$877.20	$1,193.46	$1,604.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $72.37 / $605.41 / $1,031.03	Professional		$72.37	$605.41	$1,031.03
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 $703.06 / $1,087.49 / $1,916.73	Professional		$703.06	$1,087.49	$1,916.73