Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,056.53 / $1,056.53 / $2,725.00	Facility		$1,056.53	$1,056.53	$2,725.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,029.76 / $1,056.53 / $1,455.07	Professional		$1,029.76	$1,056.53	$1,455.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,031.78 / $2,380.15 / $6,166.74	Facility		$2,031.78	$2,380.15	$6,166.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,084.06 / $1,208.51 / $2,812.90	Professional		$1,084.06	$1,208.51	$2,812.90
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $1,839.20 / $1,839.20 / $1,839.20	Professional		$1,839.20	$1,839.20	$1,839.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,622.83 / $2,163.77 / $2,921.09	Facility		$1,622.83	$2,163.77	$2,921.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,414.10 / $1,957.99 / $4,633.06	Professional		$1,414.10	$1,957.99	$4,633.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,207.83 / $1,207.83 / $2,549.46	Facility		$1,207.83	$1,207.83	$2,549.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $881.72 / $881.72 / $1,543.00	Professional		$881.72	$881.72	$1,543.00
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,207.83 / $1,207.83 / $1,207.83	Facility		$1,207.83	$1,207.83	$1,207.83
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $881.72 / $1,207.83 / $1,207.83	Professional		$881.72	$1,207.83	$1,207.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $917.90 / $1,262.11 / $1,654.63	Professional		$917.90	$1,262.11	$1,654.63
United Facility/Professional Facility Modifier Low / Median / High Price $1,055.55 / $1,055.55 / $1,055.55	Facility		$1,055.55	$1,055.55	$1,055.55
United Facility/Professional Professional Modifier Low / Median / High Price $719.65 / $1,079.48 / $1,568.12	Professional		$719.65	$1,079.48	$1,568.12