Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $239.88 / $416.87	Facility		$162.18	$239.88	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $141.25 / $208.93	Professional		$120.23	$141.25	$208.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $302.00 / $457.09	Professional		$169.82	$302.00	$457.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Facility		$199.53	$199.53	$199.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $2,691.53 / $4,786.30	Professional		$213.80	$2,691.53	$4,786.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $363.08	Facility		$112.20	$112.20	$363.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $199.53 / $251.19	Professional		$112.20	$199.53	$251.19
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $112.20 / $1,000.00	Facility		$85.11	$112.20	$1,000.00
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 Facility Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Facility		$208.93	$208.93	$208.93
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $181.97 / $346.74	Professional		$112.20	$181.97	$346.74
United Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $112.20 / $173.78	Facility		$61.66	$112.20	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $104.71 / $173.78	Professional		$72.44	$104.71	$173.78