Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $660.69 / $1,373.00	Facility		$660.69	$660.69	$1,373.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $559.49 / $660.69 / $875.38	Professional		$559.49	$660.69	$875.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,270.55 / $1,488.40 / $3,856.31	Facility		$1,270.55	$1,488.40	$3,856.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $650.86 / $677.90 / $1,759.01	Professional		$650.86	$677.90	$1,759.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $879.51 / $1,353.09 / $1,826.67	Facility		$879.51	$1,353.09	$1,826.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $879.51 / $1,217.78 / $2,897.24	Professional		$879.51	$1,217.78	$2,897.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $875.29 / $875.29 / $1,384.43	Facility		$875.29	$875.29	$1,384.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $638.96 / $638.96 / $1,118.18	Professional		$638.96	$638.96	$1,118.18
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $875.29 / $875.29 / $875.29	Facility		$875.29	$875.29	$875.29
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $638.96 / $875.29 / $875.29	Professional		$638.96	$875.29	$875.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $574.00 / $789.25 / $1,034.70	Professional		$574.00	$789.25	$1,034.70
United Facility/Professional Professional Modifier Low / Median / High Price $450.03 / $675.04 / $858.90	Professional		$450.03	$675.04	$858.90