Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,383.10 / $1,383.10 / $3,488.00	Facility		$1,383.10	$1,383.10	$3,488.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $980.39 / $1,383.10 / $1,481.37	Professional		$980.39	$1,383.10	$1,481.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,418.00 / $2,832.59 / $7,338.98	Facility		$2,418.00	$2,832.59	$7,338.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,130.95 / $1,256.21 / $3,347.60	Professional		$1,130.95	$1,256.21	$3,347.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,644.77 / $2,575.08 / $3,476.36	Facility		$1,644.77	$2,575.08	$3,476.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,673.80 / $2,317.57 / $5,513.76	Professional		$1,673.80	$2,317.57	$5,513.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,206.80 / $1,206.80 / $2,498.89	Facility		$1,206.80	$1,206.80	$2,498.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $880.96 / $880.96 / $1,541.69	Professional		$880.96	$880.96	$1,541.69
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,206.80 / $1,206.80 / $1,206.80	Facility		$1,206.80	$1,206.80	$1,206.80
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $880.96 / $1,206.80 / $1,206.80	Professional		$880.96	$1,206.80	$1,206.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,092.38 / $1,502.02 / $1,969.15	Professional		$1,092.38	$1,502.02	$1,969.15
United Facility/Professional Professional Modifier Low / Median / High Price $754.42 / $1,209.26 / $1,634.57	Professional		$754.42	$1,209.26	$1,634.57