Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,323.86 / $1,323.86 / $1,323.86	Facility		$1,323.86	$1,323.86	$1,323.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,306.28 / $1,323.86 / $1,942.86	Professional		$1,306.28	$1,323.86	$1,942.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,248.66 / $3,099.04 / $4,958.46	Facility		$2,248.66	$3,099.04	$4,958.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,698.23 / $2,122.79 / $3,491.98	Professional		$1,698.23	$2,122.79	$3,491.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $205.77 / $1,562.06 / $2,479.23	Facility		$205.77	$1,562.06	$2,479.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $173.54 / $1,547.51 / $2,603.19	Professional		$173.54	$1,547.51	$2,603.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,772.06 / $1,772.06 / $2,860.35	Facility		$1,772.06	$1,772.06	$2,860.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,506.25 / $1,772.06 / $2,831.25	Professional		$1,506.25	$1,772.06	$2,831.25
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,772.06 / $1,772.06 / $2,111.63	Facility		$1,772.06	$1,772.06	$2,111.63
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,772.06 / $1,772.06 / $2,111.63	Professional		$1,772.06	$1,772.06	$2,111.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $122.27 / $244.54 / $1,910.50	Professional		$122.27	$244.54	$1,910.50
United Facility/Professional Facility Modifier Low / Median / High Price $117.93 / $907.20 / $1,859.42	Facility		$117.93	$907.20	$1,859.42
United Facility/Professional Professional Modifier Low / Median / High Price $842.22 / $1,280.75 / $1,886.93	Professional		$842.22	$1,280.75	$1,886.93