Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $912.00 / $1,969.89 / $1,969.89	Facility		$912.00	$1,969.89	$1,969.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,969.89 / $1,969.89 / $2,028.98	Professional		$1,969.89	$1,969.89	$2,028.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,969.89 / $2,251.96 / $3,900.38	Professional		$1,969.89	$2,251.96	$3,900.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,969.89 / $1,969.89 / $2,974.53	Facility		$1,969.89	$1,969.89	$2,974.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,969.89 / $1,969.89 / $2,659.35	Professional		$1,969.89	$1,969.89	$2,659.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,858.38 / $1,858.38 / $1,969.89	Facility		$1,858.38	$1,858.38	$1,969.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,969.89 / $1,969.89 / $2,701.20	Professional		$1,969.89	$1,969.89	$2,701.20
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,296.02 / $2,296.02 / $2,296.02	Facility		$2,296.02	$2,296.02	$2,296.02
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,969.89 / $1,969.89 / $2,701.20	Professional		$1,969.89	$1,969.89	$2,701.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $50.00 / $1,968.50	Professional		$35.00	$50.00	$1,968.50
United Facility/Professional Facility Modifier Low / Median / High Price $1,969.89 / $1,969.89 / $2,702.16	Facility		$1,969.89	$1,969.89	$2,702.16
United Facility/Professional Professional Modifier Low / Median / High Price $1,969.89 / $1,969.89 / $2,517.52	Professional		$1,969.89	$1,969.89	$2,517.52