Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $831.76 / $1,348.96	Facility		$489.78	$831.76	$1,348.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $489.78 / $645.65	Professional		$489.78	$489.78	$645.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $794.33 / $1,737.80	Facility		$524.81	$794.33	$1,737.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $549.54 / $891.25	Professional		$489.78	$549.54	$891.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Facility		$501.19	$501.19	$501.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $676.08 / $676.08	Professional		$676.08	$676.08	$676.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $467.74 / $489.78	Facility		$467.74	$467.74	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $489.78 / $741.31	Professional		$489.78	$489.78	$741.31
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $467.74 / $489.78	Facility		$467.74	$467.74	$489.78
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $489.78 / $741.31	Professional		$489.78	$489.78	$741.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $616.60 / $707.95	Professional		$489.78	$616.60	$707.95
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $851.14 / $1,174.90	Professional		$501.19	$851.14	$1,174.90
United Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $501.19	Facility		$489.78	$489.78	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $489.78 / $575.44	Professional		$489.78	$489.78	$575.44