Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $295.12 / $416.87	Facility		$165.96	$295.12	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $144.54 / $208.93	Professional		$104.71	$144.54	$208.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $186.21 / $323.59	Facility		$162.18	$186.21	$323.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $173.78 / $288.40	Professional		$114.82	$173.78	$288.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $2,454.71 / $41,686.94	Facility		$162.18	$2,454.71	$41,686.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $2,754.23 / $4,786.30	Professional		$213.80	$2,754.23	$4,786.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $371.54	Facility		$114.82	$114.82	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $204.17 / $223.87	Professional		$141.25	$204.17	$223.87
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $218.78 / $1,023.29	Facility		$114.82	$218.78	$1,023.29
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Facility		$208.93	$208.93	$208.93
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $190.55 / $407.38	Professional		$147.91	$190.55	$407.38
United Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $158.49 / $173.78	Facility		$63.10	$158.49	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $104.71 / $199.53	Professional		$74.13	$104.71	$199.53