Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $629.24 / $629.24 / $1,857.00	Facility		$629.24	$629.24	$1,857.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $613.29 / $629.24 / $870.88	Professional		$613.29	$629.24	$870.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,210.08 / $1,417.56 / $3,672.77	Facility		$1,210.08	$1,417.56	$3,672.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $645.64 / $773.99 / $1,701.07	Professional		$645.64	$773.99	$1,701.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $966.52 / $1,327.35 / $1,804.17	Facility		$966.52	$1,327.35	$1,804.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $902.08 / $1,288.69 / $2,759.34	Professional		$902.08	$1,288.69	$2,759.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $908.11 / $908.11 / $2,013.58	Facility		$908.11	$908.11	$2,013.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $662.92 / $662.92 / $1,071.52	Professional		$662.92	$662.92	$1,071.52
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $908.11 / $908.11 / $908.11	Facility		$908.11	$908.11	$908.11
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $662.92 / $908.11 / $908.11	Professional		$662.92	$908.11	$908.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $546.68 / $751.69 / $985.47	Professional		$546.68	$751.69	$985.47
United Facility/Professional Facility Modifier Low / Median / High Price $1,460.51 / $1,460.51 / $1,718.25	Facility		$1,460.51	$1,460.51	$1,718.25
United Facility/Professional Professional Modifier Low / Median / High Price $428.61 / $642.91 / $990.71	Professional		$428.61	$642.91	$990.71