Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $238.46 / $649.91 / $1,156.00	Facility		$238.46	$649.91	$1,156.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $238.46 / $238.46 / $253.36	Professional		$238.46	$238.46	$253.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $255.84 / $423.01 / $707.91	Facility		$255.84	$423.01	$707.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $212.50 / $255.21 / $458.05	Professional		$212.50	$255.21	$458.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,273.75 / $2,273.75 / $3,865.38	Facility		$2,273.75	$2,273.75	$3,865.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $352.09 / $2,273.75 / $2,273.75	Professional		$352.09	$2,273.75	$2,273.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $241.21 / $253.36 / $253.36	Facility		$241.21	$253.36	$253.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $253.36 / $253.36 / $253.36	Professional		$253.36	$253.36	$253.36
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $171.72 / $241.21 / $315.86	Facility		$171.72	$241.21	$315.86
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $253.36 / $253.36 / $298.07	Professional		$253.36	$253.36	$298.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,852.68 / $1,852.68 / $2,189.53	Professional		$1,852.68	$1,852.68	$2,189.53
United Facility/Professional Professional Modifier Low / Median / High Price $248.39 / $248.39 / $308.25	Professional		$248.39	$248.39	$308.25