Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $616.60 / $1,071.52	Facility		$416.87	$616.60	$1,071.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $363.08 / $512.86	Professional		$263.03	$363.08	$512.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $12.88 / $478.63	Professional		$11.22	$12.88	$478.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $6,165.95 / $41,686.94	Facility		$407.38	$6,165.95	$41,686.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $6,918.31 / $12,302.69	Professional		$549.54	$6,918.31	$12,302.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $288.40 / $575.44	Facility		$288.40	$288.40	$575.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $512.86 / $562.34	Professional		$512.86	$512.86	$562.34
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $501.19 / $2,570.40	Facility		$288.40	$501.19	$2,570.40
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 $537.03 / $537.03 / $537.03	Facility		$537.03	$537.03	$537.03
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $467.74 / $891.25	Professional		$331.13	$467.74	$891.25
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $398.11 / $446.68	Facility		$158.49	$398.11	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $263.03 / $512.86	Professional		$186.21	$263.03	$512.86