Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $741.31 / $1,202.26	Facility		$478.63	$741.31	$1,202.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $407.38 / $630.96	Professional		$354.81	$407.38	$630.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $537.03 / $933.25	Facility		$457.09	$537.03	$933.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $66.07 / $524.81	Professional		$41.69	$66.07	$524.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $575.44	Facility		$575.44	$575.44	$575.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $7,943.28 / $13,803.84	Professional		$616.60	$7,943.28	$13,803.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $323.59 / $1,698.24	Facility		$323.59	$323.59	$1,698.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $524.81 / $660.69	Professional		$323.59	$524.81	$660.69
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $512.86 / $1,698.24	Facility		$323.59	$512.86	$1,698.24
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $323.59	Professional		$323.59	$323.59	$323.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Professional		$275.42	$275.42	$275.42
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $602.56 / $602.56	Facility		$602.56	$602.56	$602.56
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $524.81 / $1,000.00	Professional		$323.59	$524.81	$1,000.00
United Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $302.00 / $501.19	Facility		$181.97	$302.00	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $302.00 / $501.19	Professional		$213.80	$302.00	$501.19