Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $266.12 / $266.12 / $1,283.00	Facility		$266.12	$266.12	$1,283.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.99 / $266.12 / $344.26	Professional		$223.99	$266.12	$344.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $465.24 / $545.01 / $1,412.06	Facility		$465.24	$545.01	$1,412.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $241.70 / $276.02 / $644.09	Professional		$241.70	$276.02	$644.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $348.83 / $495.46 / $668.87	Facility		$348.83	$495.46	$668.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $322.05 / $445.91 / $1,060.88	Professional		$322.05	$445.91	$1,060.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $290.63 / $290.63 / $622.07	Facility		$290.63	$290.63	$622.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $212.16 / $212.16 / $290.63	Professional		$212.16	$212.16	$290.63
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $290.63 / $290.63 / $290.63	Facility		$290.63	$290.63	$290.63
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $212.16 / $290.63 / $290.63	Professional		$212.16	$290.63	$290.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $210.18 / $289.00 / $378.88	Professional		$210.18	$289.00	$378.88
United Facility/Professional Facility Modifier Low / Median / High Price $444.22 / $444.22 / $444.22	Facility		$444.22	$444.22	$444.22
United Facility/Professional Professional Modifier Low / Median / High Price $164.79 / $236.87 / $355.08	Professional		$164.79	$236.87	$355.08