Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $707.95 / $1,230.27	Facility		$478.63	$707.95	$1,230.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $416.87 / $588.84	Professional		$338.84	$416.87	$588.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $194.98 / $537.03	Professional		$169.82	$194.98	$537.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $512.86 / $588.84	Facility		$512.86	$512.86	$588.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $7,943.28 / $14,125.38	Professional		$630.96	$7,943.28	$14,125.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $331.13 / $1,071.52	Facility		$331.13	$331.13	$1,071.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $588.84 / $741.31	Professional		$331.13	$588.84	$741.31
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $524.81 / $1,071.52	Facility		$331.13	$524.81	$1,071.52
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $331.13	Professional		$331.13	$331.13	$331.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $537.03 / $1,023.29	Professional		$331.13	$537.03	$1,023.29
United Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $257.04 / $354.81	Facility		$177.83	$257.04	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $309.03 / $512.86	Professional		$213.80	$309.03	$512.86