Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $963.99 / $963.99 / $963.99	Facility		$963.99	$963.99	$963.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $963.99 / $1,023.51 / $1,876.44	Professional		$963.99	$1,023.51	$1,876.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,637.39 / $2,256.60 / $3,610.56	Facility		$1,637.39	$2,256.60	$3,610.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,468.86 / $1,875.80 / $3,068.97	Professional		$1,468.86	$1,875.80	$3,068.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $149.84 / $1,180.64 / $1,805.28	Facility		$149.84	$1,180.64	$1,805.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $126.37 / $1,150.86 / $1,895.54	Professional		$126.37	$1,150.86	$1,895.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,217.05 / $1,217.05 / $2,527.53	Facility		$1,217.05	$1,217.05	$2,527.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,034.49 / $1,034.49 / $2,685.94	Professional		$1,034.49	$1,034.49	$2,685.94
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,217.05 / $1,217.05 / $1,674.92	Facility		$1,217.05	$1,217.05	$1,674.92
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,207.23 / $1,217.05 / $1,597.37	Professional		$1,207.23	$1,217.05	$1,597.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.00 / $192.00 / $1,500.00	Professional		$96.00	$192.00	$1,500.00
United Facility/Professional Professional Modifier Low / Median / High Price $649.99 / $1,080.96 / $1,667.38	Professional		$649.99	$1,080.96	$1,667.38