Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $719.76 / $719.76 / $2,445.00	Facility		$719.76	$719.76	$2,445.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $663.25 / $719.76 / $891.49	Professional		$663.25	$719.76	$891.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,258.32 / $1,474.07 / $3,819.17	Facility		$1,258.32	$1,474.07	$3,819.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $653.72 / $784.46 / $1,768.87	Professional		$653.72	$784.46	$1,768.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,005.05 / $1,340.06 / $1,876.08	Facility		$1,005.05	$1,340.06	$1,876.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $938.04 / $1,340.06 / $2,869.34	Professional		$938.04	$1,340.06	$2,869.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $837.35 / $837.35 / $1,960.01	Facility		$837.35	$837.35	$1,960.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $611.27 / $611.27 / $1,038.44	Professional		$611.27	$611.27	$1,038.44
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $837.35 / $837.35 / $837.35	Facility		$837.35	$837.35	$837.35
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $611.27 / $837.35 / $837.35	Professional		$611.27	$837.35	$837.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $568.47 / $781.64 / $1,024.74	Professional		$568.47	$781.64	$1,024.74
United Facility/Professional Facility Modifier Low / Median / High Price $452.72 / $662.58 / $1,072.05	Facility		$452.72	$662.58	$1,072.05
United Facility/Professional Professional Modifier Low / Median / High Price $445.70 / $668.54 / $971.52	Professional		$445.70	$668.54	$971.52