Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $239.88 / $338.84	Facility		$134.90	$239.88	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $114.82 / $169.82	Professional		$85.11	$114.82	$169.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $151.36 / $263.03	Facility		$131.83	$151.36	$263.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $20.42 / $186.21	Professional		$16.98	$20.42	$186.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $1,995.26 / $41,686.94	Facility		$131.83	$1,995.26	$41,686.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $2,238.72 / $3,981.07	Professional		$173.78	$2,238.72	$3,981.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $302.00	Facility		$93.33	$93.33	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $165.96 / $181.97	Professional		$114.82	$165.96	$181.97
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $147.91 / $588.84	Facility		$95.50	$147.91	$588.84
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Professional		$114.82	$114.82	$114.82
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $158.49 / $331.13	Professional		$120.23	$158.49	$331.13
United Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $128.82 / $141.25	Facility		$51.29	$128.82	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $85.11 / $162.18	Professional		$60.26	$85.11	$162.18