Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $353.75 / $353.75 / $892.00	Facility		$353.75	$353.75	$892.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $313.36 / $353.75 / $464.38	Professional		$313.36	$353.75	$464.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $680.29 / $796.93 / $2,064.77	Facility		$680.29	$796.93	$2,064.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $362.97 / $382.88 / $941.82	Professional		$362.97	$382.88	$941.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $491.14 / $724.48 / $978.05	Facility		$491.14	$724.48	$978.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $470.91 / $652.03 / $1,551.26	Professional		$470.91	$652.03	$1,551.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $468.67 / $468.67 / $807.56	Facility		$468.67	$468.67	$807.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $342.13 / $342.13 / $598.73	Professional		$342.13	$342.13	$598.73
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $468.67 / $468.67 / $468.67	Facility		$468.67	$468.67	$468.67
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $342.13 / $468.67 / $468.67	Professional		$342.13	$468.67	$468.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $307.33 / $422.58 / $554.01	Professional		$307.33	$422.58	$554.01
United Facility/Professional Facility Modifier Low / Median / High Price $383.20 / $383.20 / $383.20	Facility		$383.20	$383.20	$383.20
United Facility/Professional Professional Modifier Low / Median / High Price $240.96 / $361.44 / $481.80	Professional		$240.96	$361.44	$481.80