Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $707.95 / $1,096.48	Facility		$123.03	$707.95	$1,096.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $50.12 / $1,174.90	Professional		$30.20	$50.12	$1,174.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $724.44 / $1,318.26	Professional		$549.54	$724.44	$1,318.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $114.82 / $323.59	Facility		$70.79	$114.82	$323.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $120.23 / $363.08	Professional		$107.15	$120.23	$363.08
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 $416.87 / $630.96 / $912.01	Professional		$416.87	$630.96	$912.01
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $616.60 / $870.96	Professional		$426.58	$616.60	$870.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $93.33 / $173.78	Professional		$52.48	$93.33	$173.78
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $407.38 / $851.14	Professional		$173.78	$407.38	$851.14
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $54.95 / $75.86	Professional		$39.81	$54.95	$75.86