Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $562.80 / $562.80 / $1,409.00	Facility		$562.80	$562.80	$1,409.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $548.54 / $562.80 / $919.27	Professional		$548.54	$562.80	$919.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,082.31 / $1,267.88 / $3,284.97	Facility		$1,082.31	$1,267.88	$3,284.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $577.47 / $692.27 / $1,519.73	Professional		$577.47	$692.27	$1,519.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $864.47 / $1,152.61 / $1,556.04	Facility		$864.47	$1,152.61	$1,556.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $749.20 / $1,152.61 / $2,467.98	Professional		$749.20	$1,152.61	$2,467.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $812.21 / $812.21 / $1,512.71	Facility		$812.21	$812.21	$1,512.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $592.91 / $592.91 / $958.38	Professional		$592.91	$592.91	$958.38
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $812.21 / $812.21 / $812.21	Facility		$812.21	$812.21	$812.21
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $592.91 / $812.21 / $812.21	Professional		$592.91	$812.21	$812.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $488.96 / $672.33 / $881.42	Professional		$488.96	$672.33	$881.42
United Facility/Professional Professional Modifier Low / Median / High Price $383.35 / $575.03 / $866.39	Professional		$383.35	$575.03	$866.39