Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $389.05 / $954.99	Facility		$208.93	$389.05	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $234.42 / $588.84	Professional		$190.55	$234.42	$588.84
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 $190.55 / $245.47 / $371.54	Professional		$190.55	$245.47	$371.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $173.78 / $204.17	Facility		$30.90	$173.78	$204.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $616.60	Facility		$186.21	$186.21	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $288.40 / $537.03	Professional		$199.53	$288.40	$537.03
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $831.76 / $1,288.25	Facility		$407.38	$831.76	$1,288.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $295.12 / $537.03	Professional		$199.53	$295.12	$537.03
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 $218.78 / $316.23 / $467.74	Professional		$218.78	$316.23	$467.74
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 $173.78 / $245.47 / $436.52	Professional		$173.78	$245.47	$436.52