Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $399.40 / $399.40 / $1,175.00	Facility		$399.40	$399.40	$1,175.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $280.19 / $399.40 / $424.67	Professional		$280.19	$399.40	$424.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $698.26 / $817.98 / $2,119.32	Facility		$698.26	$817.98	$2,119.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $340.68 / $362.75 / $966.70	Professional		$340.68	$362.75	$966.70
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $632.08 / $632.08 / $632.08	Professional		$632.08	$632.08	$632.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $483.35 / $743.62 / $1,003.89	Facility		$483.35	$743.62	$1,003.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $483.35 / $669.26 / $1,592.24	Professional		$483.35	$669.26	$1,592.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $378.92 / $378.92 / $613.97	Facility		$378.92	$378.92	$613.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $276.61 / $276.61 / $613.97	Professional		$276.61	$276.61	$613.97
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $378.92 / $378.92 / $613.97	Facility		$378.92	$378.92	$613.97
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $276.61 / $378.92 / $378.92	Professional		$276.61	$378.92	$378.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $315.44 / $433.74 / $568.63	Professional		$315.44	$433.74	$568.63
United Facility/Professional Professional Modifier Low / Median / High Price $218.61 / $343.00 / $472.02	Professional		$218.61	$343.00	$472.02