Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,902.62 / $1,902.62 / $2,481.00	Facility		$1,902.62	$1,902.62	$2,481.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,902.62 / $1,902.62 / $1,959.70	Professional		$1,902.62	$1,902.62	$1,959.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,902.62 / $2,188.01 / $3,694.12	Professional		$1,902.62	$2,188.01	$3,694.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,902.62 / $1,902.62 / $2,872.96	Facility		$1,902.62	$1,902.62	$2,872.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,902.62 / $1,902.62 / $2,568.54	Professional		$1,902.62	$1,902.62	$2,568.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,794.93 / $1,794.93 / $1,902.62	Facility		$1,794.93	$1,794.93	$1,902.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,902.62 / $1,902.62 / $2,692.39	Professional		$1,902.62	$1,902.62	$2,692.39
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,349.92 / $2,349.92 / $2,349.92	Facility		$2,349.92	$2,349.92	$2,349.92
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,902.62 / $1,902.62 / $2,700.00	Professional		$1,902.62	$1,902.62	$2,700.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,092.88 / $2,242.35 / $2,584.91	Professional		$2,092.88	$2,242.35	$2,584.91
United Facility/Professional Professional Modifier Low / Median / High Price $1,902.62 / $1,902.62 / $2,431.55	Professional		$1,902.62	$1,902.62	$2,431.55