Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $713.50 / $713.50 / $1,769.00	Facility		$713.50	$713.50	$1,769.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $713.50 / $713.50 / $734.91	Professional		$713.50	$713.50	$734.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $713.50 / $827.66 / $1,423.78	Professional		$713.50	$827.66	$1,423.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $713.50 / $713.50 / $1,212.95	Facility		$713.50	$713.50	$1,212.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $713.50 / $713.50 / $963.23	Professional		$713.50	$713.50	$963.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $673.11 / $673.11 / $713.50	Facility		$673.11	$673.11	$713.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $713.50 / $713.50 / $1,009.67	Professional		$713.50	$713.50	$1,009.67
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,351.50 / $1,351.50 / $1,351.50	Facility		$1,351.50	$1,351.50	$1,351.50
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $713.50 / $713.50 / $1,552.40	Professional		$713.50	$713.50	$1,552.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $784.85 / $1,035.60 / $1,267.83	Professional		$784.85	$1,035.60	$1,267.83
United Facility/Professional Facility Modifier Low / Median / High Price $1,189.82 / $1,189.82 / $1,189.82	Facility		$1,189.82	$1,189.82	$1,189.82
United Facility/Professional Professional Modifier Low / Median / High Price $713.50 / $713.50 / $917.56	Professional		$713.50	$713.50	$917.56