Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $632.00 / $1,172.56 / $1,172.56	Facility		$632.00	$1,172.56	$1,172.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,172.56 / $1,172.56 / $1,207.73	Professional		$1,172.56	$1,172.56	$1,207.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,172.56 / $1,348.44 / $2,283.09	Professional		$1,172.56	$1,348.44	$2,283.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,172.56 / $1,172.56 / $1,770.57	Facility		$1,172.56	$1,172.56	$1,770.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,172.56 / $1,172.56 / $1,582.96	Professional		$1,172.56	$1,172.56	$1,582.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,106.19 / $1,106.19 / $1,172.56	Facility		$1,106.19	$1,106.19	$1,172.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,172.56 / $1,172.56 / $1,334.40	Professional		$1,172.56	$1,172.56	$1,334.40
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,106.19 / $1,172.56 / $1,172.56	Facility		$1,106.19	$1,172.56	$1,172.56
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,172.56 / $1,172.56 / $1,659.28	Professional		$1,172.56	$1,172.56	$1,659.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,142.68 / $1,281.92 / $1,289.81	Professional		$1,142.68	$1,281.92	$1,289.81
United Facility/Professional Professional Modifier Low / Median / High Price $1,172.56 / $1,172.56 / $1,631.15	Professional		$1,172.56	$1,172.56	$1,631.15