Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $656.12 / $656.12 / $767.67	Facility		$656.12	$656.12	$767.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $675.81	Professional		$656.12	$656.12	$675.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $749.28 / $1,273.92	Professional		$656.12	$749.28	$1,273.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $656.12 / $656.12 / $1,115.40	Facility		$656.12	$656.12	$1,115.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $885.76	Professional		$656.12	$656.12	$885.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $618.98 / $618.98 / $656.12	Facility		$618.98	$618.98	$656.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $928.48	Professional		$656.12	$656.12	$928.48
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,417.80 / $1,417.80 / $1,417.80	Facility		$1,417.80	$1,417.80	$1,417.80
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $928.48	Professional		$656.12	$656.12	$928.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $721.73 / $1,133.15 / $1,417.09	Professional		$721.73	$1,133.15	$1,417.09
United Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $843.77	Professional		$656.12	$656.12	$843.77