Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $93.33 / $1,230.27	Facility		$64.57	$93.33	$1,230.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $66.07 / $100.00	Professional		$57.54	$66.07	$100.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,318.26 / $1,348.96	Facility		$1,148.15	$1,318.26	$1,348.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $181.97 / $275.42	Professional		$128.82	$181.97	$275.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $43.65 / $64.57	Facility		$19.95	$43.65	$64.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $46.77 / $114.82	Facility		$33.88	$46.77	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $91.20 / $173.78	Professional		$63.10	$91.20	$173.78
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $1,071.52 / $1,698.24	Facility		$63.10	$1,071.52	$1,698.24
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $93.33 / $173.78	Professional		$63.10	$93.33	$173.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $32.36 / $33.11	Professional		$17.38	$32.36	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $660.69 / $660.69	Facility		$660.69	$660.69	$660.69
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $123.03 / $208.93	Professional		$97.72	$123.03	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $407.38 / $1,288.25	Facility		$407.38	$407.38	$1,288.25
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $107.15 / $173.78	Professional		$81.28	$107.15	$173.78