Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $425.79 / $425.79 / $1,486.00	Facility		$425.79	$425.79	$1,486.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $345.91 / $425.79 / $527.97	Professional		$345.91	$425.79	$527.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $744.38 / $872.01 / $2,259.31	Facility		$744.38	$872.01	$2,259.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $386.72 / $431.11 / $1,030.56	Professional		$386.72	$431.11	$1,030.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $594.55 / $792.74 / $1,070.20	Facility		$594.55	$792.74	$1,070.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $537.21 / $743.82 / $1,697.41	Professional		$537.21	$743.82	$1,697.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.80 / $512.80 / $968.52	Facility		$512.80	$512.80	$968.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $374.35 / $374.35 / $655.11	Professional		$374.35	$374.35	$655.11
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $512.80 / $512.80 / $512.80	Facility		$512.80	$512.80	$512.80
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $374.35 / $512.80 / $512.80	Professional		$374.35	$512.80	$512.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $428.57 / $589.29 / $772.56	Professional		$428.57	$589.29	$772.56
United Facility/Professional Professional Modifier Low / Median / High Price $263.66 / $377.86 / $539.89	Professional		$263.66	$377.86	$539.89