Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $891.25 / $1,445.44	Facility		$524.81	$891.25	$1,445.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $741.31	Professional		$524.81	$524.81	$741.31
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $977.24 / $2,691.53	Facility		$562.34	$977.24	$2,691.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $588.84 / $1,000.00	Professional		$524.81	$588.84	$1,000.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Facility		$549.54	$549.54	$549.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Professional		$741.31	$741.31	$741.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $524.81	Facility		$489.78	$489.78	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $1,380.38	Professional		$524.81	$524.81	$1,380.38
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $524.81	Facility		$489.78	$489.78	$524.81
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $1,380.38	Professional		$524.81	$524.81	$1,380.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $660.69 / $758.58	Professional		$524.81	$660.69	$758.58
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $933.25 / $1,288.25	Professional		$562.34	$933.25	$1,288.25
United Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $524.81 / $549.54	Facility		$524.81	$524.81	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $707.95	Professional		$524.81	$524.81	$707.95