Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $323.59 / $954.99	Facility		$223.87	$323.59	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $251.19 / $676.08	Professional		$204.17	$251.19	$676.08
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 $169.82 / $223.87 / $354.81	Professional		$169.82	$223.87	$354.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $177.83 / $218.78	Facility		$39.81	$177.83	$218.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $602.56	Facility		$190.55	$190.55	$602.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $302.00 / $549.54	Professional		$204.17	$302.00	$549.54
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $831.76 / $1,288.25	Facility		$416.87	$831.76	$1,288.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $309.03 / $549.54	Professional		$208.93	$309.03	$549.54
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 $489.78 / $489.78 / $489.78	Facility		$489.78	$489.78	$489.78
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $338.84 / $501.19	Professional		$234.42	$338.84	$501.19
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 $158.49 / $257.04 / $467.74	Professional		$158.49	$257.04	$467.74