Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $748.85 / $1,625.00 / $2,546.09	Facility		$748.85	$1,625.00	$2,546.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $748.85 / $771.31 / $1,665.46	Professional		$748.85	$771.31	$1,665.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $808.76 / $1,307.86 / $2,149.19	Facility		$808.76	$1,307.86	$2,149.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $748.85 / $748.85 / $1,262.56	Professional		$748.85	$748.85	$1,262.56
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $1,003.46 / $1,003.46 / $1,003.46	Facility		$1,003.46	$1,003.46	$1,003.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $748.85 / $748.85 / $1,273.05	Facility		$748.85	$748.85	$1,273.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $748.85 / $748.85 / $1,010.95	Professional		$748.85	$748.85	$1,010.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $706.46 / $706.46 / $748.84	Facility		$706.46	$706.46	$748.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $748.84 / $748.84 / $1,115.33	Professional		$748.84	$748.84	$1,115.33
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,356.26 / $1,356.26 / $1,356.26	Facility		$1,356.26	$1,356.26	$1,356.26
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $748.84 / $748.84 / $1,115.33	Professional		$748.84	$748.84	$1,115.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $817.19 / $936.06 / $1,077.20	Professional		$817.19	$936.06	$1,077.20
United Facility/Professional Facility Modifier Low / Median / High Price $748.84 / $748.84 / $748.84	Facility		$748.84	$748.84	$748.84
United Facility/Professional Professional Modifier Low / Median / High Price $748.85 / $748.85 / $809.96	Professional		$748.85	$748.85	$809.96