Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $524.81 / $776.25	Facility		$47.86	$524.81	$776.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $50.12 / $812.83	Professional		$30.20	$50.12	$812.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $524.81 / $645.65	Professional		$398.11	$524.81	$645.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $102.33 / $281.84	Facility		$63.10	$102.33	$281.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $107.15 / $323.59	Professional		$95.50	$107.15	$323.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Facility		$61.66	$61.66	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $436.52 / $645.65	Professional		$295.12	$436.52	$645.65
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $436.52 / $602.56	Professional		$302.00	$436.52	$602.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $64.57 / $123.03	Professional		$52.48	$64.57	$123.03
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $354.81 / $741.31	Professional		$151.36	$354.81	$741.31
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $54.95 / $75.86	Professional		$39.81	$54.95	$75.86