Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $657.07 / $657.07 / $3,363.00	Facility		$657.07	$657.07	$3,363.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $640.41 / $657.07 / $1,080.81	Professional		$640.41	$657.07	$1,080.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,263.58 / $1,480.25 / $3,835.19	Facility		$1,263.58	$1,480.25	$3,835.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $674.19 / $808.22 / $1,774.29	Professional		$674.19	$808.22	$1,774.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,009.26 / $1,345.68 / $1,816.67	Facility		$1,009.26	$1,345.68	$1,816.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $874.69 / $1,345.68 / $2,881.37	Professional		$874.69	$1,345.68	$2,881.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $870.50 / $870.50 / $1,824.41	Facility		$870.50	$870.50	$1,824.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $635.47 / $635.47 / $1,112.06	Professional		$635.47	$635.47	$1,112.06
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $870.50 / $870.50 / $870.50	Facility		$870.50	$870.50	$870.50
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $635.47 / $870.50 / $870.50	Professional		$635.47	$870.50	$870.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $570.86 / $784.93 / $1,029.05	Professional		$570.86	$784.93	$1,029.05
United Facility/Professional Professional Modifier Low / Median / High Price $447.56 / $671.35 / $1,034.53	Professional		$447.56	$671.35	$1,034.53