Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,195.20 / $1,195.20 / $1,862.00	Facility		$1,195.20	$1,195.20	$1,862.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,195.20 / $1,195.20 / $1,269.90	Professional		$1,195.20	$1,195.20	$1,269.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $291.27 / $358.26 / $1,675.64	Professional		$291.27	$358.26	$1,675.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $422.70 / $530.83 / $648.79	Facility		$422.70	$530.83	$648.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,269.90 / $1,269.90 / $1,269.90	Facility		$1,269.90	$1,269.90	$1,269.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,269.90 / $1,269.90 / $1,361.70	Professional		$1,269.90	$1,269.90	$1,361.70
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,269.90 / $1,269.90 / $1,269.90	Facility		$1,269.90	$1,269.90	$1,269.90
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,269.90 / $1,269.90 / $1,494.00	Professional		$1,269.90	$1,269.90	$1,494.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $291.27 / $349.52 / $422.34	Professional		$291.27	$349.52	$422.34
United Facility/Professional Professional Modifier Low / Median / High Price $1,245.00 / $1,245.00 / $1,545.05	Professional		$1,245.00	$1,245.00	$1,545.05