Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,300.00 / $3,919.00 / $6,824.98	Facility		$1,300.00	$3,919.00	$6,824.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,300.00 / $1,300.00 / $4,010.00	Professional		$1,300.00	$1,300.00	$4,010.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,228.00 / $6,086.85 / $7,160.74	Facility		$1,228.00	$6,086.85	$7,160.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $427.70 / $1,238.27 / $2,017.10	Professional		$427.70	$1,238.27	$2,017.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $92.03 / $528.04 / $902.88	Facility		$92.03	$528.04	$902.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $99.24 / $569.45 / $2,581.21	Professional		$99.24	$569.45	$2,581.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,171.58 / $5,739.79 / $5,739.79	Facility		$1,171.58	$5,739.79	$5,739.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $575.22 / $790.26 / $1,471.68	Professional		$575.22	$790.26	$1,471.68
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,171.58 / $2,482.71 / $5,739.79	Facility		$1,171.58	$2,482.71	$5,739.79
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $619.27 / $790.26 / $1,361.68	Professional		$619.27	$790.26	$1,361.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $90.96 / $118.34 / $156.91	Professional		$90.96	$118.34	$156.91
United Facility/Professional Professional Modifier Low / Median / High Price $1,830.35 / $2,708.53 / $5,168.27	Professional		$1,830.35	$2,708.53	$5,168.27