Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $805.94 / $805.94 / $2,213.00	Facility		$805.94	$805.94	$2,213.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $614.07 / $805.94 / $856.93	Professional		$614.07	$805.94	$856.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,408.98 / $1,650.56 / $4,276.45	Facility		$1,408.98	$1,650.56	$4,276.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $731.99 / $775.39 / $1,950.66	Professional		$731.99	$775.39	$1,950.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $975.33 / $1,500.51 / $2,025.69	Facility		$975.33	$1,500.51	$2,025.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $975.33 / $1,350.46 / $3,212.89	Professional		$975.33	$1,350.46	$3,212.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,057.34 / $1,057.34 / $1,650.87	Facility		$1,057.34	$1,057.34	$1,650.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $771.87 / $771.87 / $1,247.64	Professional		$771.87	$771.87	$1,247.64
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,057.34 / $1,057.34 / $1,057.34	Facility		$1,057.34	$1,057.34	$1,057.34
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $771.87 / $1,057.34 / $1,057.34	Professional		$771.87	$1,057.34	$1,057.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $636.53 / $875.23 / $1,147.43	Professional		$636.53	$875.23	$1,147.43
United Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $692.12 / $958.49	Professional		$478.63	$692.12	$958.49