Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $915.09 / $915.09 / $1,227.00	Facility		$915.09	$915.09	$1,227.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $915.09 / $915.09 / $942.54	Professional		$915.09	$915.09	$942.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $915.09 / $1,045.03 / $1,776.73	Professional		$915.09	$1,045.03	$1,776.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $915.09 / $915.09 / $1,381.79	Facility		$915.09	$915.09	$1,381.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $915.09 / $915.09 / $1,235.36	Professional		$915.09	$915.09	$1,235.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $863.29 / $863.29 / $915.09	Facility		$863.29	$863.29	$915.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $915.09 / $915.09 / $1,191.07	Professional		$915.09	$915.09	$1,191.07
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,417.80 / $1,417.80 / $1,417.80	Facility		$1,417.80	$1,417.80	$1,417.80
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $915.09 / $915.09 / $1,294.93	Professional		$915.09	$915.09	$1,294.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $544.43 / $783.19 / $1,189.61	Professional		$544.43	$783.19	$1,189.61
United Facility/Professional Professional Modifier Low / Median / High Price $915.09 / $915.09 / $1,176.81	Professional		$915.09	$915.09	$1,176.81