Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $741.31 / $1,202.26	Facility		$478.63	$741.31	$1,202.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $407.38 / $630.96	Professional		$354.81	$407.38	$630.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $33.88 / $501.19	Professional		$28.84	$33.88	$501.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $575.44	Facility		$575.44	$575.44	$575.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $7,943.28 / $13,803.84	Professional		$616.60	$7,943.28	$13,803.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $323.59 / $1,071.52	Facility		$323.59	$323.59	$1,071.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $575.44 / $724.44	Professional		$323.59	$575.44	$724.44
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $512.86 / $1,071.52	Facility		$323.59	$512.86	$1,071.52
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $323.59	Professional		$323.59	$323.59	$323.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $50.12 / $50.12	Professional		$39.81	$50.12	$50.12
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $602.56 / $602.56	Facility		$602.56	$602.56	$602.56
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $524.81 / $1,000.00	Professional		$323.59	$524.81	$1,000.00
United Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $323.59 / $501.19	Facility		$181.97	$323.59	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $302.00 / $501.19	Professional		$213.80	$302.00	$501.19