Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $748.80 / $1,609.92 / $3,452.72	Facility		$748.80	$1,609.92	$3,452.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $748.80 / $748.80 / $1,174.00	Professional		$748.80	$748.80	$1,174.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $826.49 / $1,029.59 / $1,656.44	Facility		$826.49	$1,029.59	$1,656.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $374.40 / $374.40 / $1,118.82	Professional		$374.40	$374.40	$1,118.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $704.34 / $982.80 / $1,404.00	Facility		$704.34	$982.80	$1,404.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $795.60 / $1,216.80 / $2,246.40	Professional		$795.60	$1,216.80	$2,246.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $608.40 / $963.71 / $3,194.10	Facility		$608.40	$963.71	$3,194.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $428.30 / $608.40 / $1,813.58	Professional		$428.30	$608.40	$1,813.58
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $608.40 / $963.71 / $3,619.41	Facility		$608.40	$963.71	$3,619.41
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $428.30 / $547.55 / $2,036.98	Professional		$428.30	$547.55	$2,036.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $702.00 / $807.30 / $1,123.20	Professional		$702.00	$807.30	$1,123.20
United Facility/Professional Professional Modifier Low / Median / High Price $393.12 / $561.60 / $1,363.75	Professional		$393.12	$561.60	$1,363.75