Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,296.00 / $1,296.00 / $1,500.00	Facility		$1,296.00	$1,296.00	$1,500.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,296.00 / $1,296.00 / $1,377.00	Professional		$1,296.00	$1,296.00	$1,377.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,193.30 / $1,842.18	Professional		$1,000.00	$1,193.30	$1,842.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,259.74 / $1,300.77 / $1,871.05	Facility		$1,259.74	$1,300.77	$1,871.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,259.74 / $1,259.74 / $1,259.74	Professional		$1,259.74	$1,259.74	$1,259.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,377.00 / $1,377.00 / $1,377.00	Facility		$1,377.00	$1,377.00	$1,377.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,377.00 / $1,377.00 / $1,377.00	Professional		$1,377.00	$1,377.00	$1,377.00
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,377.00 / $1,377.00 / $1,377.00	Facility		$1,377.00	$1,377.00	$1,377.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,377.00 / $1,377.00 / $1,620.00	Professional		$1,377.00	$1,377.00	$1,620.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $50.00	Professional		$30.00	$30.00	$50.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,350.00 / $1,350.00 / $1,757.70	Professional		$1,350.00	$1,350.00	$1,757.70