Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,303.88 / $4,723.00 / $11,627.00	Facility		$1,303.88	$4,723.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,206.17 / $1,309.94 / $2,400.89	Professional		$1,206.17	$1,309.94	$2,400.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,802.00 / $13,734.14 / $24,478.90	Facility		$2,802.00	$13,734.14	$24,478.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,032.15 / $1,368.65 / $2,270.52	Professional		$1,032.15	$1,368.65	$2,270.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,246.99 / $1,496.39 / $1,852.10	Facility		$1,246.99	$1,496.39	$1,852.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,053.83 / $1,371.69 / $1,621.09	Professional		$1,053.83	$1,371.69	$1,621.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $425.00 / $1,200.00 / $21,571.00	Facility		$425.00	$1,200.00	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,167.92 / $1,727.08 / $2,621.17	Professional		$1,167.92	$1,727.08	$2,621.17
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $425.00 / $600.00 / $1,491.88	Facility		$425.00	$600.00	$1,491.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,233.53 / $1,745.79 / $2,621.17	Professional		$1,233.53	$1,745.79	$2,621.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $112.40 / $1,085.92 / $1,737.16	Professional		$112.40	$1,085.92	$1,737.16
United Facility/Professional Facility Modifier Low / Median / High Price $650.00 / $2,883.00 / $6,111.00	Facility		$650.00	$2,883.00	$6,111.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,100.44 / $1,594.14 / $2,702.27	Professional		$1,100.44	$1,594.14	$2,702.27