Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $275.42 / $389.05	Facility		$154.88	$275.42	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $138.04 / $194.98	Professional		$114.82	$138.04	$194.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $173.78 / $302.00	Facility		$151.36	$173.78	$302.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $794.33 / $1,412.54	Professional		$173.78	$794.33	$1,412.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $2,290.87 / $41,686.94	Facility		$151.36	$2,290.87	$41,686.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $2,570.40 / $4,570.88	Professional		$199.53	$2,570.40	$4,570.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $616.60	Facility		$107.15	$107.15	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $190.55 / $208.93	Professional		$107.15	$190.55	$208.93
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $169.82 / $676.08	Facility		$109.65	$169.82	$676.08
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Professional		$107.15	$107.15	$107.15
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $181.97 / $380.19	Professional		$138.04	$181.97	$380.19
United Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $147.91 / $162.18	Facility		$58.88	$147.91	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $97.72 / $204.17	Professional		$69.18	$97.72	$204.17