Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,045.15 / $2,267.98 / $3,247.28	Facility		$1,045.15	$2,267.98	$3,247.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,045.15 / $1,055.59 / $2,902.71	Professional		$1,045.15	$1,055.59	$2,902.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,128.76 / $1,825.35 / $2,999.58	Facility		$1,128.76	$1,825.35	$2,999.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,045.15 / $1,045.15 / $1,824.18	Professional		$1,045.15	$1,045.15	$1,824.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,045.15 / $1,045.15 / $1,776.76	Facility		$1,045.15	$1,045.15	$1,776.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,045.15 / $1,045.15 / $1,410.95	Professional		$1,045.15	$1,045.15	$1,410.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $985.99 / $985.99 / $1,045.15	Facility		$985.99	$985.99	$1,045.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,045.15 / $1,045.15 / $2,118.38	Professional		$1,045.15	$1,045.15	$2,118.38
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $985.99 / $985.99 / $1,045.15	Facility		$985.99	$985.99	$1,045.15
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,045.15 / $1,045.15 / $2,118.38	Professional		$1,045.15	$1,045.15	$2,118.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,148.55 / $1,306.43 / $1,514.00	Professional		$1,148.55	$1,306.43	$1,514.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,273.13 / $1,273.13 / $1,273.13	Facility		$1,273.13	$1,273.13	$1,273.13
United Facility/Professional Professional Modifier Low / Median / High Price $1,045.15 / $1,045.15 / $1,360.79	Professional		$1,045.15	$1,045.15	$1,360.79