Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $147.91 / $954.99	Facility		$102.33	$147.91	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $114.82 / $309.03	Professional		$95.50	$114.82	$309.03
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 $128.82 / $169.82 / $263.03	Professional		$128.82	$169.82	$263.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $77.62 / $100.00	Facility		$23.44	$77.62	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $93.33 / $309.03	Facility		$83.18	$93.33	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $169.82 / $288.40	Professional		$100.00	$169.82	$288.40
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $831.76 / $1,288.25	Facility		$173.78	$831.76	$1,288.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $169.82 / $316.23	Professional		$100.00	$169.82	$316.23
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 $112.20 / $162.18 / $234.42	Professional		$112.20	$162.18	$234.42
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 $97.72 / $131.83 / $218.78	Professional		$97.72	$131.83	$218.78