Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,300.00 / $2,795.00 / $5,005.00	Facility		$1,300.00	$2,795.00	$5,005.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $975.00 / $1,300.00 / $1,625.00	Professional		$975.00	$1,300.00	$1,625.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,434.88 / $1,787.50 / $2,875.76	Facility		$1,434.88	$1,787.50	$2,875.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $650.00 / $650.00 / $1,755.00	Professional		$650.00	$650.00	$1,755.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,222.81 / $1,706.25 / $2,437.50	Facility		$1,222.81	$1,706.25	$2,437.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,381.25 / $2,112.50 / $3,900.00	Professional		$1,381.25	$2,112.50	$3,900.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,056.25 / $1,673.10 / $5,545.31	Facility		$1,056.25	$1,673.10	$5,545.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $743.49 / $1,056.25 / $3,148.46	Professional		$743.49	$1,056.25	$3,148.46
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,056.25 / $1,673.10 / $6,284.68	Facility		$1,056.25	$1,673.10	$6,284.68
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $743.49 / $950.62 / $3,536.67	Professional		$743.49	$950.62	$3,536.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,218.75 / $1,401.56 / $1,950.00	Professional		$1,218.75	$1,401.56	$1,950.00
United Facility/Professional Professional Modifier Low / Median / High Price $682.50 / $975.00 / $2,128.75	Professional		$682.50	$975.00	$2,128.75