Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $490.08 / $1,216.00 / $1,549.88	Facility		$490.08	$1,216.00	$1,549.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $490.08 / $490.08 / $1,362.42	Professional		$490.08	$490.08	$1,362.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $551.34 / $942.95 / $1,549.54	Facility		$551.34	$942.95	$1,549.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $510.50 / $530.00 / $893.58	Professional		$510.50	$530.00	$893.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $737.42 / $737.42 / $1,253.60	Facility		$737.42	$737.42	$1,253.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $546.24 / $546.24 / $737.42	Professional		$546.24	$546.24	$737.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $520.71 / $520.71 / $539.52	Facility		$520.71	$520.71	$539.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $520.71 / $520.71 / $819.27	Professional		$520.71	$520.71	$819.27
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $520.71 / $520.71 / $539.52	Facility		$520.71	$520.71	$539.52
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $520.71 / $520.71 / $819.27	Professional		$520.71	$520.71	$819.27
United Facility/Professional Professional Modifier Low / Median / High Price $510.50 / $510.50 / $710.16	Professional		$510.50	$510.50	$710.16