Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $882.90 / $4,723.00 / $11,627.00	Facility		$882.90	$4,723.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $838.87 / $972.79 / $1,955.42	Professional		$838.87	$972.79	$1,955.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,142.00 / $15,258.77 / $26,788.67	Facility		$4,142.00	$15,258.77	$26,788.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $820.02 / $1,167.32 / $1,818.80	Professional		$820.02	$1,167.32	$1,818.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $869.62 / $948.67 / $1,381.39	Facility		$869.62	$948.67	$1,381.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,003.79 / $1,023.08 / $1,302.09	Professional		$1,003.79	$1,023.08	$1,302.09
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 $958.70 / $1,348.59 / $1,863.32	Professional		$958.70	$1,348.59	$1,863.32
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,123.78 / $1,123.78 / $1,123.78	Facility		$1,123.78	$1,123.78	$1,123.78
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $976.57 / $1,390.53 / $1,863.32	Professional		$976.57	$1,390.53	$1,863.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $104.14 / $759.30 / $1,221.25	Professional		$104.14	$759.30	$1,221.25
United Facility/Professional Facility Modifier Low / Median / High Price $1,480.00 / $3,086.00 / $6,111.00	Facility		$1,480.00	$3,086.00	$6,111.00
United Facility/Professional Professional Modifier Low / Median / High Price $820.08 / $1,243.34 / $1,852.59	Professional		$820.08	$1,243.34	$1,852.59