Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,187.76 / $1,187.76 / $2,406.00	Facility		$1,187.76	$1,187.76	$2,406.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $894.60 / $1,187.76 / $1,479.21	Professional		$894.60	$1,187.76	$1,479.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,284.14 / $2,675.77 / $6,932.68	Facility		$2,284.14	$2,675.77	$6,932.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,095.74 / $1,218.71 / $3,162.27	Professional		$1,095.74	$1,218.71	$3,162.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,550.73 / $2,432.52 / $3,283.90	Facility		$1,550.73	$2,432.52	$3,283.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,581.14 / $2,189.27 / $5,208.51	Professional		$1,581.14	$2,189.27	$5,208.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,573.58 / $1,573.58 / $2,376.62	Facility		$1,573.58	$1,573.58	$2,376.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,148.71 / $1,148.71 / $2,022.59	Professional		$1,148.71	$1,148.71	$2,022.59
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,573.58 / $1,573.58 / $1,573.58	Facility		$1,573.58	$1,573.58	$1,573.58
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,148.71 / $1,573.58 / $1,573.58	Professional		$1,148.71	$1,573.58	$1,573.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,031.91 / $1,418.87 / $1,860.15	Professional		$1,031.91	$1,418.87	$1,860.15
United Facility/Professional Facility Modifier Low / Median / High Price $1,261.08 / $1,261.08 / $1,261.08	Facility		$1,261.08	$1,261.08	$1,261.08
United Facility/Professional Professional Modifier Low / Median / High Price $758.48 / $1,213.55 / $1,544.08	Professional		$758.48	$1,213.55	$1,544.08