Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $646.65 / $646.65 / $1,622.00	Facility		$646.65	$646.65	$1,622.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $519.34 / $646.65 / $722.75	Professional		$519.34	$646.65	$722.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,130.50 / $1,324.33 / $3,431.23	Facility		$1,130.50	$1,324.33	$3,431.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $587.33 / $649.58 / $1,581.97	Professional		$587.33	$649.58	$1,581.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $902.96 / $1,203.94 / $1,625.32	Facility		$902.96	$1,203.94	$1,625.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $837.29 / $1,159.33 / $2,577.88	Professional		$837.29	$1,159.33	$2,577.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $711.81 / $711.81 / $1,509.54	Facility		$711.81	$711.81	$1,509.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $519.62 / $519.62 / $909.34	Professional		$519.62	$519.62	$909.34
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $711.81 / $711.81 / $711.81	Facility		$711.81	$711.81	$711.81
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $519.62 / $711.81 / $711.81	Professional		$519.62	$711.81	$711.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $217.50 / $299.06 / $392.07	Professional		$217.50	$299.06	$392.07
United Facility/Professional Professional Modifier Low / Median / High Price $400.42 / $573.85 / $810.58	Professional		$400.42	$573.85	$810.58