Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $877.39 / $877.39 / $2,876.00	Facility		$877.39	$877.39	$2,876.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $768.82 / $877.39 / $1,071.89	Professional		$768.82	$877.39	$1,071.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,533.90 / $1,796.91 / $4,655.62	Facility		$1,533.90	$1,796.91	$4,655.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $796.88 / $934.82 / $2,146.48	Professional		$796.88	$934.82	$2,146.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,225.16 / $1,633.55 / $2,280.90	Facility		$1,225.16	$1,633.55	$2,280.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,143.49 / $1,633.55 / $3,497.76	Professional		$1,143.49	$1,633.55	$3,497.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,030.36 / $1,030.36 / $2,227.44	Facility		$1,030.36	$1,030.36	$2,227.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $752.17 / $752.17 / $1,358.26	Professional		$752.17	$752.17	$1,358.26
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,030.36 / $1,030.36 / $1,030.36	Facility		$1,030.36	$1,030.36	$1,030.36
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $752.17 / $1,030.36 / $1,030.36	Professional		$752.17	$1,030.36	$1,030.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $217.50 / $299.06 / $392.07	Professional		$217.50	$299.06	$392.07
United Facility/Professional Professional Modifier Low / Median / High Price $543.29 / $796.42 / $1,227.25	Professional		$543.29	$796.42	$1,227.25