Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $659.24 / $659.24 / $1,638.00	Facility		$659.24	$659.24	$1,638.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $595.38 / $659.24 / $820.55	Professional		$595.38	$659.24	$820.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,267.76 / $1,485.13 / $3,847.84	Facility		$1,267.76	$1,485.13	$3,847.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $656.97 / $676.42 / $1,755.15	Professional		$656.97	$676.42	$1,755.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $945.58 / $1,350.12 / $1,822.66	Facility		$945.58	$1,350.12	$1,822.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $877.58 / $1,215.10 / $2,890.88	Professional		$877.58	$1,215.10	$2,890.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $957.73 / $957.73 / $1,402.05	Facility		$957.73	$957.73	$1,402.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $699.14 / $699.14 / $1,122.59	Professional		$699.14	$699.14	$1,122.59
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $957.73 / $957.73 / $957.73	Facility		$957.73	$957.73	$957.73
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $699.14 / $957.73 / $957.73	Professional		$699.14	$957.73	$957.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $572.74 / $787.52 / $1,032.44	Professional		$572.74	$787.52	$1,032.44
United Facility/Professional Facility Modifier Low / Median / High Price $595.23 / $595.23 / $595.23	Facility		$595.23	$595.23	$595.23
United Facility/Professional Professional Modifier Low / Median / High Price $449.04 / $673.56 / $857.01	Professional		$449.04	$673.56	$857.01