Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $958.71 / $958.71 / $958.71	Facility		$958.71	$958.71	$958.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $949.38 / $958.71 / $1,706.72	Professional		$949.38	$958.71	$1,706.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,343.32 / $1,350.80 / $3,095.62	Professional		$1,343.32	$1,350.80	$3,095.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $161.59 / $274.89 / $1,068.06	Facility		$161.59	$274.89	$1,068.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $152.61 / $264.99 / $1,617.60	Professional		$152.61	$264.99	$1,617.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $504.00 / $504.00 / $2,064.88	Facility		$504.00	$504.00	$2,064.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $428.40 / $504.00 / $2,081.25	Professional		$428.40	$504.00	$2,081.25
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $504.00 / $504.00 / $1,259.36	Facility		$504.00	$504.00	$1,259.36
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $428.40 / $504.00 / $504.00	Professional		$428.40	$504.00	$504.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $718.93 / $1,078.39 / $1,497.77	Professional		$718.93	$1,078.39	$1,497.77
United Facility/Professional Professional Modifier Low / Median / High Price $598.00 / $1,018.46 / $1,784.80	Professional		$598.00	$1,018.46	$1,784.80