Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $940.46 / $940.46 / $2,024.00	Facility		$940.46	$940.46	$2,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $708.34 / $940.46 / $1,099.94	Professional		$708.34	$940.46	$1,099.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,808.56 / $2,118.66 / $5,489.24	Facility		$1,808.56	$2,118.66	$5,489.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $867.59 / $939.59 / $2,503.86	Professional		$867.59	$939.59	$2,503.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,227.85 / $1,926.05 / $2,600.17	Facility		$1,227.85	$1,926.05	$2,600.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,251.93 / $1,733.45 / $4,124.06	Professional		$1,251.93	$1,733.45	$4,124.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $902.63 / $902.63 / $1,915.46	Facility		$902.63	$902.63	$1,915.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $658.92 / $658.92 / $1,153.10	Professional		$658.92	$658.92	$1,153.10
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $902.63 / $902.63 / $902.63	Facility		$902.63	$902.63	$902.63
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $658.92 / $902.63 / $902.63	Professional		$658.92	$902.63	$902.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $817.05 / $1,123.45 / $1,472.84	Professional		$817.05	$1,123.45	$1,472.84
United Facility/Professional Professional Modifier Low / Median / High Price $600.54 / $960.88 / $1,222.58	Professional		$600.54	$960.88	$1,222.58