Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $735.05 / $735.05 / $1,512.00	Facility		$735.05	$735.05	$1,512.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $735.05 / $757.10	Professional		$735.05	$735.05	$757.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $852.65 / $1,427.17	Professional		$735.05	$852.65	$1,427.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $735.05 / $735.05 / $1,109.93	Facility		$735.05	$735.05	$1,109.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $735.05 / $992.32	Professional		$735.05	$735.05	$992.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $693.44 / $693.44 / $735.05	Facility		$693.44	$693.44	$735.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $735.05 / $1,040.16	Professional		$735.05	$735.05	$1,040.16
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,887.00 / $1,887.00 / $1,887.00	Facility		$1,887.00	$1,887.00	$1,887.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $735.05 / $1,340.94	Professional		$735.05	$735.05	$1,340.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $808.55 / $975.85 / $1,215.52	Professional		$808.55	$975.85	$1,215.52
United Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $735.05 / $939.39	Professional		$735.05	$735.05	$939.39