Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $681.77 / $681.77 / $1,512.00	Facility		$681.77	$681.77	$1,512.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $578.54 / $681.77 / $968.39	Professional		$578.54	$681.77	$968.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,311.09 / $1,535.89 / $3,979.34	Facility		$1,311.09	$1,535.89	$3,979.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $694.94 / $699.53 / $1,815.13	Professional		$694.94	$699.53	$1,815.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $913.73 / $1,396.26 / $1,884.95	Facility		$913.73	$1,396.26	$1,884.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $907.57 / $1,256.63 / $2,989.67	Professional		$907.57	$1,256.63	$2,989.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $930.44 / $930.44 / $1,493.42	Facility		$930.44	$930.44	$1,493.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $679.22 / $679.22 / $1,160.97	Professional		$679.22	$679.22	$1,160.97
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $930.44 / $930.44 / $930.44	Facility		$930.44	$930.44	$930.44
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $679.22 / $930.44 / $930.44	Professional		$679.22	$930.44	$930.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $592.31 / $814.42 / $1,067.71	Professional		$592.31	$814.42	$1,067.71
United Facility/Professional Professional Modifier Low / Median / High Price $464.39 / $696.58 / $889.53	Professional		$464.39	$696.58	$889.53