Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $619.00 / $1,152.00 / $1,152.00	Facility		$619.00	$1,152.00	$1,152.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,152.00 / $1,152.00 / $1,224.00	Professional		$1,152.00	$1,152.00	$1,224.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $386.49 / $444.46 / $663.60	Professional		$386.49	$444.46	$663.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $560.89 / $704.38 / $860.90	Facility		$560.89	$704.38	$860.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,224.00 / $1,224.00 / $1,224.00	Facility		$1,224.00	$1,224.00	$1,224.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,224.00 / $1,224.00 / $1,224.00	Professional		$1,224.00	$1,224.00	$1,224.00
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,224.00 / $1,224.00 / $1,224.00	Facility		$1,224.00	$1,224.00	$1,224.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,224.00 / $1,224.00 / $1,440.00	Professional		$1,224.00	$1,224.00	$1,440.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $50.00 / $425.13	Professional		$40.00	$50.00	$425.13
United Facility/Professional Professional Modifier Low / Median / High Price $1,200.00 / $1,200.00 / $1,562.40	Professional		$1,200.00	$1,200.00	$1,562.40