Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $239.88 / $446.68	Facility		$144.54	$239.88	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $204.17 / $338.84	Professional		$128.82	$204.17	$338.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,137.96 / $3,981.07	Facility		$707.95	$2,137.96	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $147.91 / $229.09	Professional		$112.20	$147.91	$229.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $158.49	Facility		$134.90	$134.90	$158.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $218.78 / $21,379.62	Facility		$151.36	$218.78	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $229.09 / $389.05	Professional		$147.91	$229.09	$389.05
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $229.09 / $389.05	Professional		$147.91	$229.09	$389.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $51.29	Professional		$32.36	$33.11	$51.29
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $346.74 / $346.74	Facility		$346.74	$346.74	$346.74
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $251.19 / $389.05	Professional		$131.83	$251.19	$389.05
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $912.01 / $2,951.21	Facility		$316.23	$912.01	$2,951.21
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $190.55 / $331.13	Professional		$117.49	$190.55	$331.13