Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $794.33 / $1,288.25	Facility		$436.52	$794.33	$1,288.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $208.93 / $302.00	Professional		$173.78	$208.93	$302.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $204.17 / $338.84	Professional		$158.49	$204.17	$338.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $1,862.09 / $41,686.94	Facility		$186.21	$1,862.09	$41,686.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $2,454.71 / $5,495.41	Professional		$245.47	$2,454.71	$5,495.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $309.03	Facility		$131.83	$131.83	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $275.42 / $933.25	Professional		$239.88	$275.42	$933.25
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $309.03 / $398.11	Facility		$131.83	$309.03	$398.11
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $302.00 / $933.25	Professional		$239.88	$302.00	$933.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $50.12 / $60.26	Professional		$39.81	$50.12	$60.26
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Facility		$213.80	$213.80	$213.80
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $70.79 / $75.86	Professional		$50.12	$70.79	$75.86
United Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $173.78 / $416.87	Facility		$134.90	$173.78	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $181.97 / $331.13	Professional		$141.25	$181.97	$331.13