Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,058.56 / $2,058.56 / $4,018.00	Facility		$2,058.56	$2,058.56	$4,018.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,816.02 / $2,058.56 / $3,049.67	Professional		$1,816.02	$2,058.56	$3,049.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,958.76 / $4,637.52 / $12,015.40	Facility		$3,958.76	$4,637.52	$12,015.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,112.19 / $2,262.55 / $5,480.70	Professional		$2,112.19	$2,262.55	$5,480.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,919.49 / $4,215.93 / $5,691.51	Facility		$2,919.49	$4,215.93	$5,691.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,740.35 / $3,794.34 / $9,027.15	Professional		$2,740.35	$3,794.34	$9,027.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,970.85 / $2,970.85 / $4,704.04	Facility		$2,970.85	$2,970.85	$4,704.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,168.71 / $2,168.71 / $3,505.47	Professional		$2,168.71	$2,168.71	$3,505.47
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,970.85 / $2,970.85 / $2,970.85	Facility		$2,970.85	$2,970.85	$2,970.85
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $2,168.71 / $2,970.85 / $2,970.85	Professional		$2,168.71	$2,970.85	$2,970.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,788.46 / $2,459.13 / $3,223.92	Professional		$1,788.46	$2,459.13	$3,223.92
United Facility/Professional Professional Modifier Low / Median / High Price $1,402.19 / $2,103.28 / $2,847.13	Professional		$1,402.19	$2,103.28	$2,847.13