Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $999.51 / $999.51 / $2,343.00	Facility		$999.51	$999.51	$2,343.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $810.02 / $999.51 / $1,169.02	Professional		$810.02	$999.51	$1,169.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,922.13 / $2,251.69 / $5,833.95	Facility		$1,922.13	$2,251.69	$5,833.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $992.14 / $1,025.56 / $2,661.10	Professional		$992.14	$1,025.56	$2,661.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,362.41 / $2,047.00 / $2,763.45	Facility		$1,362.41	$2,047.00	$2,763.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,330.55 / $1,842.30 / $4,383.04	Professional		$1,330.55	$1,842.30	$4,383.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,324.18 / $1,324.18 / $2,128.75	Facility		$1,324.18	$1,324.18	$2,128.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $966.65 / $966.65 / $1,691.64	Professional		$966.65	$966.65	$1,691.64
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,324.18 / $1,324.18 / $1,324.18	Facility		$1,324.18	$1,324.18	$1,324.18
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $966.65 / $1,324.18 / $1,324.18	Professional		$966.65	$1,324.18	$1,324.18
United Facility/Professional Facility Modifier Low / Median / High Price $640.00 / $640.00 / $640.00	Facility		$640.00	$640.00	$640.00
United Facility/Professional Professional Modifier Low / Median / High Price $680.82 / $1,021.22 / $1,299.35	Professional		$680.82	$1,021.22	$1,299.35