Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $263.03 / $691.83	Facility		$102.33	$263.03	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $102.33 / $229.09	Professional		$81.28	$102.33	$229.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $288.40 / $302.00	Facility		$257.04	$288.40	$302.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $70.79 / $144.54	Professional		$42.66	$70.79	$144.54
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $66.07 / $97.72	Facility		$32.36	$66.07	$97.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $74.13 / $407.38	Facility		$70.79	$74.13	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $125.89 / $223.87	Professional		$81.28	$125.89	$223.87
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $218.78 / $501.19	Facility		$131.83	$218.78	$501.19
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $120.23 / $223.87	Professional		$81.28	$120.23	$223.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $125.89 / $229.09	Professional		$102.33	$125.89	$229.09
United Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $81.28 / $251.19	Facility		$33.11	$81.28	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $102.33 / $177.83	Professional		$67.61	$102.33	$177.83