Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $281.84 / $954.99	Facility		$194.98	$281.84	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $213.80 / $630.96	Professional		$173.78	$213.80	$630.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,000.00 / $1,047.13	Facility		$891.25	$1,000.00	$1,047.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $186.21 / $302.00	Professional		$141.25	$186.21	$302.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $158.49 / $190.55	Facility		$30.90	$158.49	$190.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $537.03	Facility		$173.78	$173.78	$537.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $245.47 / $457.09	Professional		$169.82	$245.47	$457.09
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $831.76 / $1,288.25	Facility		$380.19	$831.76	$1,288.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $263.03 / $457.09	Professional		$169.82	$263.03	$457.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Facility		$489.78	$489.78	$489.78
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $288.40 / $436.52	Professional		$208.93	$288.40	$436.52
United Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $954.99	Facility		$302.00	$302.00	$954.99
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $218.78 / $407.38	Professional		$131.83	$218.78	$407.38