Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $909.29 / $909.29 / $909.29	Facility		$909.29	$909.29	$909.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $909.29 / $909.41 / $1,222.46	Professional		$909.29	$909.41	$1,222.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,544.49 / $2,128.58 / $3,405.72	Facility		$1,544.49	$2,128.58	$3,405.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,126.02 / $1,407.52 / $2,315.37	Professional		$1,126.02	$1,407.52	$2,315.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $127.72 / $1,106.85 / $1,702.86	Facility		$127.72	$1,106.85	$1,702.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $119.39 / $1,085.58 / $1,788.00	Professional		$119.39	$1,085.58	$1,788.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,116.58 / $1,116.58 / $1,983.91	Facility		$1,116.58	$1,116.58	$1,983.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $949.10 / $1,116.58 / $1,974.00	Professional		$949.10	$1,116.58	$1,974.00
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,116.58 / $1,116.58 / $1,116.58	Facility		$1,116.58	$1,116.58	$1,116.58
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,116.58 / $1,116.58 / $1,116.58	Professional		$1,116.58	$1,116.58	$1,116.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.33 / $188.67 / $1,474.02	Professional		$94.33	$188.67	$1,474.02
United Facility/Professional Professional Modifier Low / Median / High Price $572.85 / $859.28 / $1,251.13	Professional		$572.85	$859.28	$1,251.13