Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,452.25 / $1,452.25 / $1,594.00	Facility		$1,452.25	$1,452.25	$1,594.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $1,452.25 / $1,495.82	Professional		$1,452.25	$1,452.25	$1,495.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $1,670.08 / $2,819.68	Professional		$1,452.25	$1,670.08	$2,819.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,452.25 / $1,452.25 / $2,468.83	Facility		$1,452.25	$1,452.25	$2,468.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $1,452.25 / $1,960.54	Professional		$1,452.25	$1,452.25	$1,960.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,370.05 / $1,370.05 / $1,452.25	Facility		$1,370.05	$1,370.05	$1,452.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $1,452.25 / $2,055.07	Professional		$1,452.25	$1,452.25	$2,055.07
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,550.00 / $2,550.00 / $2,550.00	Facility		$2,550.00	$2,550.00	$2,550.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $1,452.25 / $2,055.07	Professional		$1,452.25	$1,452.25	$2,055.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,597.47 / $1,713.78 / $1,897.54	Professional		$1,597.47	$1,713.78	$1,897.54
United Facility/Professional Facility Modifier Low / Median / High Price $1,452.25 / $1,452.25 / $2,999.83	Facility		$1,452.25	$1,452.25	$2,999.83
United Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $1,452.25 / $1,867.59	Professional		$1,452.25	$1,452.25	$1,867.59