Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,323.35 / $2,871.67 / $4,281.82	Facility		$1,323.35	$2,871.67	$4,281.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,336.58 / $1,762.29	Professional		$1,323.35	$1,336.58	$1,762.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,429.22 / $2,269.55 / $3,771.55	Facility		$1,429.22	$2,269.55	$3,771.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,482.15 / $2,203.37	Professional		$1,323.35	$1,482.15	$2,203.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,323.35 / $1,323.35 / $1,989.11	Facility		$1,323.35	$1,323.35	$1,989.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,323.35 / $1,786.52	Professional		$1,323.35	$1,323.35	$1,786.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,248.44 / $1,323.35 / $1,444.55	Facility		$1,248.44	$1,323.35	$1,444.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,323.35 / $1,771.61	Professional		$1,323.35	$1,323.35	$1,771.61
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,323.35 / $1,444.55 / $2,158.41	Facility		$1,323.35	$1,444.55	$2,158.41
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,323.35 / $1,872.66	Professional		$1,323.35	$1,323.35	$1,872.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,376.79 / $1,589.00 / $1,918.85	Professional		$1,376.79	$1,589.00	$1,918.85
United Facility/Professional Professional Modifier Low / Median / High Price $1,320.84 / $1,323.35 / $1,640.03	Professional		$1,320.84	$1,323.35	$1,640.03