Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,288.31 / $1,288.31 / $5,413.00	Facility		$1,288.31	$1,288.31	$5,413.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,109.16 / $1,288.31 / $1,575.09	Professional		$1,109.16	$1,288.31	$1,575.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,252.29 / $2,638.46 / $6,836.01	Facility		$2,252.29	$2,638.46	$6,836.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,170.00 / $1,333.75 / $3,118.18	Professional		$1,170.00	$1,333.75	$3,118.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,798.95 / $2,398.60 / $3,238.11	Facility		$1,798.95	$2,398.60	$3,238.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,679.02 / $2,347.34 / $5,135.88	Professional		$1,679.02	$2,347.34	$5,135.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,703.99 / $1,703.99 / $3,056.42	Facility		$1,703.99	$1,703.99	$3,056.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,243.91 / $1,243.91 / $1,994.38	Professional		$1,243.91	$1,243.91	$1,994.38
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,703.99 / $1,703.99 / $1,703.99	Facility		$1,703.99	$1,703.99	$1,703.99
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,243.91 / $1,703.99 / $1,703.99	Professional		$1,243.91	$1,703.99	$1,703.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,017.50 / $1,399.06 / $1,834.17	Professional		$1,017.50	$1,399.06	$1,834.17
United Facility/Professional Facility Modifier Low / Median / High Price $1,520.62 / $1,520.62 / $1,520.62	Facility		$1,520.62	$1,520.62	$1,520.62
United Facility/Professional Professional Modifier Low / Median / High Price $797.75 / $1,138.71 / $1,712.03	Professional		$797.75	$1,138.71	$1,712.03