Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $363.08 / $588.84	Facility		$234.42	$363.08	$588.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $204.17 / $295.12	Professional		$173.78	$204.17	$295.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $263.03 / $457.09	Facility		$229.09	$263.03	$457.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $53.70 / $257.04	Professional		$45.71	$53.70	$257.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $281.84	Facility		$169.82	$169.82	$281.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $3,890.45 / $6,760.83	Professional		$302.00	$3,890.45	$6,760.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $524.81	Facility		$162.18	$162.18	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $281.84 / $354.81	Professional		$162.18	$281.84	$354.81
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $257.04 / $524.81	Facility		$162.18	$257.04	$524.81
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Facility		$295.12	$295.12	$295.12
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $257.04 / $489.78	Professional		$162.18	$257.04	$489.78
United Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $162.18 / $245.47	Facility		$89.13	$162.18	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $147.91 / $245.47	Professional		$104.71	$147.91	$245.47