Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,443.41 / $1,443.41 / $3,552.00	Facility		$1,443.41	$1,443.41	$3,552.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,252.17 / $1,443.41 / $2,049.23	Professional		$1,252.17	$1,443.41	$2,049.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,775.78 / $3,251.71 / $8,424.89	Facility		$2,775.78	$3,251.71	$8,424.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,464.14 / $1,489.31 / $3,842.93	Professional		$1,464.14	$1,489.31	$3,842.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,150.44 / $2,956.10 / $3,990.74	Facility		$2,150.44	$2,956.10	$3,990.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,921.47 / $2,660.49 / $6,329.60	Professional		$1,921.47	$2,660.49	$6,329.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,523.27 / $1,523.27 / $3,138.26	Facility		$1,523.27	$1,523.27	$3,138.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,111.99 / $1,111.99 / $1,945.98	Professional		$1,111.99	$1,111.99	$1,945.98
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,523.27 / $1,523.27 / $1,523.27	Facility		$1,523.27	$1,523.27	$1,523.27
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,111.99 / $1,523.27 / $1,523.27	Professional		$1,111.99	$1,523.27	$1,523.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,254.01 / $1,724.27 / $2,260.52	Professional		$1,254.01	$1,724.27	$2,260.52
United Facility/Professional Facility Modifier Low / Median / High Price $1,624.58 / $1,624.58 / $1,624.58	Facility		$1,624.58	$1,624.58	$1,624.58
United Facility/Professional Professional Modifier Low / Median / High Price $983.17 / $1,474.76 / $1,876.43	Professional		$983.17	$1,474.76	$1,876.43