Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,376.10 / $1,376.10 / $3,022.00	Facility		$1,376.10	$1,376.10	$3,022.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,143.88 / $1,376.10 / $1,761.38	Professional		$1,143.88	$1,376.10	$1,761.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,646.34 / $3,100.08 / $8,032.01	Facility		$2,646.34	$3,100.08	$8,032.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,401.07 / $1,425.16 / $3,663.72	Professional		$1,401.07	$1,425.16	$3,663.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,831.86 / $2,818.25 / $3,804.64	Facility		$1,831.86	$2,818.25	$3,804.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,831.86 / $2,536.42 / $6,034.44	Professional		$1,831.86	$2,536.42	$6,034.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,823.10 / $1,823.10 / $3,067.57	Facility		$1,823.10	$1,823.10	$3,067.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,330.86 / $1,330.86 / $2,329.01	Professional		$1,330.86	$1,330.86	$2,329.01
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,823.10 / $1,823.10 / $1,823.10	Facility		$1,823.10	$1,823.10	$1,823.10
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,330.86 / $1,823.10 / $1,823.10	Professional		$1,330.86	$1,823.10	$1,823.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,461.20 / $2,009.16 / $2,634.01	Professional		$1,461.20	$2,009.16	$2,634.01
United Facility/Professional Professional Modifier Low / Median / High Price $937.33 / $1,405.99 / $1,793.37	Professional		$937.33	$1,405.99	$1,793.37