Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,640.93 / $1,640.93 / $2,085.00	Facility		$1,640.93	$1,640.93	$2,085.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,640.93 / $1,640.93 / $1,690.16	Professional		$1,640.93	$1,640.93	$1,690.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,640.93 / $1,870.66 / $3,186.02	Professional		$1,640.93	$1,870.66	$3,186.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,640.93 / $1,640.93 / $2,477.80	Facility		$1,640.93	$1,640.93	$2,477.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,640.93 / $1,640.93 / $2,215.26	Professional		$1,640.93	$1,640.93	$2,215.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,548.05 / $1,548.05 / $1,640.93	Facility		$1,548.05	$1,548.05	$1,640.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,640.93 / $1,640.93 / $1,640.93	Professional		$1,640.93	$1,640.93	$1,640.93
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,571.96 / $1,571.96 / $1,571.96	Facility		$1,571.96	$1,571.96	$1,571.96
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,640.93 / $1,640.93 / $2,169.73	Professional		$1,640.93	$1,640.93	$2,169.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $50.00 / $1,805.02	Professional		$40.00	$50.00	$1,805.02
United Facility/Professional Professional Modifier Low / Median / High Price $1,640.93 / $1,640.93 / $2,061.01	Professional		$1,640.93	$1,640.93	$2,061.01