Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $572.96 / $1,128.73 / $1,753.26	Facility		$572.96	$1,128.73	$1,753.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $564.66 / $572.96 / $1,306.34	Professional		$564.66	$572.96	$1,306.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $618.79 / $1,000.67 / $1,644.40	Facility		$618.79	$1,000.67	$1,644.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $572.96 / $572.96 / $966.01	Professional		$572.96	$572.96	$966.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $572.96 / $572.96 / $974.03	Facility		$572.96	$572.96	$974.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $572.96 / $572.96 / $773.50	Professional		$572.96	$572.96	$773.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $540.53 / $540.53 / $572.96	Facility		$540.53	$540.53	$572.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $572.96 / $572.96 / $931.53	Professional		$572.96	$572.96	$931.53
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $540.53 / $540.53 / $572.96	Facility		$540.53	$540.53	$572.96
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $572.96 / $572.96 / $931.53	Professional		$572.96	$572.96	$931.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $50.00 / $50.00	Professional		$40.00	$50.00	$50.00
United Facility/Professional Professional Modifier Low / Median / High Price $572.96 / $572.96 / $750.58	Professional		$572.96	$572.96	$750.58