Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $165.96 / $954.99	Facility		$114.82	$165.96	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $131.83 / $346.74	Professional		$107.15	$131.83	$346.74
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 $154.88 / $223.87 / $354.81	Professional		$154.88	$223.87	$354.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $91.20 / $114.82	Facility		$23.44	$91.20	$114.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $446.68	Facility		$97.72	$97.72	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $199.53 / $389.05	Professional		$112.20	$199.53	$389.05
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $831.76 / $1,288.25	Facility		$204.17	$831.76	$1,288.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $199.53 / $416.87	Professional		$112.20	$199.53	$416.87
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 $128.82 / $186.21 / $275.42	Professional		$128.82	$186.21	$275.42
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 $112.20 / $162.18 / $295.12	Professional		$112.20	$162.18	$295.12