Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $577.52 / $577.52 / $1,335.00	Facility		$577.52	$577.52	$1,335.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $492.30 / $577.52 / $803.02	Professional		$492.30	$577.52	$803.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,110.60 / $1,301.04 / $3,370.87	Facility		$1,110.60	$1,301.04	$3,370.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $592.55 / $602.98 / $1,537.58	Professional		$592.55	$602.98	$1,537.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $768.79 / $1,182.76 / $1,596.73	Facility		$768.79	$1,182.76	$1,596.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $768.79 / $1,064.48 / $2,532.53	Professional		$768.79	$1,064.48	$2,532.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $765.11 / $765.11 / $1,311.51	Facility		$765.11	$765.11	$1,311.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $558.53 / $558.53 / $977.43	Professional		$558.53	$558.53	$977.43
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $765.11 / $765.11 / $765.11	Facility		$765.11	$765.11	$765.11
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $558.53 / $765.11 / $765.11	Professional		$558.53	$765.11	$765.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $639.44 / $879.23 / $1,152.67	Professional		$639.44	$879.23	$1,152.67
United Facility/Professional Professional Modifier Low / Median / High Price $393.38 / $590.05 / $771.82	Professional		$393.38	$590.05	$771.82