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 $169.82 / $208.93 / $302.00	Professional		$169.82	$208.93	$302.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $204.17 / $407.38	Professional		$158.49	$204.17	$407.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $1,905.46 / $41,686.94	Facility		$186.21	$1,905.46	$41,686.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $2,570.40 / $5,495.41	Professional		$245.47	$2,570.40	$5,495.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $309.03	Facility		$138.04	$138.04	$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 $138.04 / $309.03 / $724.44	Facility		$138.04	$309.03	$724.44
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 $426.58 / $426.58 / $426.58	Facility		$426.58	$426.58	$426.58
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 $269.15 / $354.81 / $831.76	Facility		$269.15	$354.81	$831.76
United Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $380.19 / $676.08	Professional		$288.40	$380.19	$676.08