Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,112.24 / $1,112.24 / $2,808.00	Facility		$1,112.24	$1,112.24	$2,808.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $858.38 / $1,112.24 / $1,546.88	Professional		$858.38	$1,112.24	$1,546.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,138.91 / $2,505.65 / $6,491.90	Facility		$2,138.91	$2,505.65	$6,491.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,031.08 / $1,141.22 / $2,961.21	Professional		$1,031.08	$1,141.22	$2,961.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,480.61 / $2,277.86 / $3,075.11	Facility		$1,480.61	$2,277.86	$3,075.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,480.61 / $2,050.07 / $4,877.35	Professional		$1,480.61	$2,050.07	$4,877.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,473.53 / $1,473.53 / $2,307.77	Facility		$1,473.53	$1,473.53	$2,307.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,075.68 / $1,075.68 / $1,522.00	Professional		$1,075.68	$1,075.68	$1,522.00
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,473.53 / $1,473.53 / $1,473.53	Facility		$1,473.53	$1,473.53	$1,473.53
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,075.68 / $1,473.53 / $1,473.53	Professional		$1,075.68	$1,473.53	$1,473.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $966.29 / $1,328.65 / $1,741.86	Professional		$966.29	$1,328.65	$1,741.86
United Facility/Professional Professional Modifier Low / Median / High Price $713.72 / $1,136.39 / $1,451.72	Professional		$713.72	$1,136.39	$1,451.72