Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,482.52 / $1,482.52 / $3,393.00	Facility		$1,482.52	$1,482.52	$3,393.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,218.52 / $1,482.52 / $2,239.08	Professional		$1,218.52	$1,482.52	$2,239.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,850.99 / $3,339.82 / $8,653.17	Facility		$2,850.99	$3,339.82	$8,653.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,492.48 / $1,521.14 / $3,947.06	Professional		$1,492.48	$1,521.14	$3,947.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,973.53 / $3,036.20 / $4,098.87	Facility		$1,973.53	$3,036.20	$4,098.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,973.53 / $2,732.58 / $6,501.11	Professional		$1,973.53	$2,732.58	$6,501.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,552.76 / $1,552.76 / $3,331.69	Facility		$1,552.76	$1,552.76	$3,331.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,133.51 / $1,133.51 / $2,524.54	Professional		$1,133.51	$1,133.51	$2,524.54
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,552.76 / $1,552.76 / $1,552.76	Facility		$1,552.76	$1,552.76	$1,552.76
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,133.51 / $1,552.76 / $1,552.76	Professional		$1,133.51	$1,552.76	$1,552.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,288.00 / $1,771.00 / $2,321.78	Professional		$1,288.00	$1,771.00	$2,321.78
United Facility/Professional Professional Modifier Low / Median / High Price $1,009.82 / $1,514.72 / $1,927.28	Professional		$1,009.82	$1,514.72	$1,927.28