Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $223.87 / $380.19	Facility		$151.36	$223.87	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $131.83 / $190.55	Professional		$112.20	$131.83	$190.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $12.02 / $165.96	Professional		$9.55	$12.02	$165.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Facility		$181.97	$181.97	$181.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $2,511.89 / $4,466.84	Professional		$194.98	$2,511.89	$4,466.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $338.84	Facility		$104.71	$104.71	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $181.97 / $229.09	Professional		$104.71	$181.97	$229.09
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $104.71 / $933.25	Facility		$79.43	$104.71	$933.25
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 $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $169.82 / $316.23	Professional		$104.71	$169.82	$316.23
United Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $104.71 / $158.49	Facility		$57.54	$104.71	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $95.50 / $158.49	Professional		$67.61	$95.50	$158.49