Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $549.54 / $776.25	Facility		$302.00	$549.54	$776.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $263.03 / $389.05	Professional		$213.80	$263.03	$389.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $338.84 / $588.84	Facility		$295.12	$338.84	$588.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.76 / $16.98 / $407.38	Professional		$6.76	$16.98	$407.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $4,466.84 / $41,686.94	Facility		$302.00	$4,466.84	$41,686.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $5,011.87 / $8,912.51	Professional		$398.11	$5,011.87	$8,912.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $1,230.27	Facility		$208.93	$208.93	$1,230.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $371.54 / $407.38	Professional		$208.93	$371.54	$407.38
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $331.13 / $1,318.26	Facility		$213.80	$331.13	$1,318.26
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Professional		$208.93	$208.93	$208.93
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Facility		$389.05	$389.05	$389.05
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $354.81 / $741.31	Professional		$275.42	$354.81	$741.31
United Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $288.40 / $323.59	Facility		$117.49	$288.40	$323.59
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $194.98 / $371.54	Professional		$134.90	$194.98	$371.54