Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $469.72 / $469.72 / $1,630.00	Facility		$469.72	$469.72	$1,630.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $421.17 / $469.72 / $624.22	Professional		$421.17	$469.72	$624.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $821.18 / $961.98 / $2,492.41	Facility		$821.18	$961.98	$2,492.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.62 / $511.94 / $1,154.36	Professional		$426.62	$511.94	$1,154.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $655.90 / $900.77 / $1,224.33	Facility		$655.90	$900.77	$1,224.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $612.16 / $874.53 / $1,872.54	Professional		$612.16	$874.53	$1,872.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $565.73 / $565.73 / $1,259.08	Facility		$565.73	$565.73	$1,259.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $412.98 / $412.98 / $722.72	Professional		$412.98	$412.98	$722.72
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $565.73 / $565.73 / $565.73	Facility		$565.73	$565.73	$565.73
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $412.98 / $565.73 / $565.73	Professional		$412.98	$565.73	$565.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $370.98 / $510.10 / $668.74	Professional		$370.98	$510.10	$668.74
United Facility/Professional Professional Modifier Low / Median / High Price $290.86 / $432.40 / $656.56	Professional		$290.86	$432.40	$656.56