Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $177.83 / $954.99	Facility		$123.03	$177.83	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $154.88 / $389.05	Professional		$123.03	$154.88	$389.05
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 $112.20 / $147.91 / $229.09	Professional		$112.20	$147.91	$229.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $20.42 / $100.00 / $120.23	Facility		$20.42	$100.00	$120.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $467.74	Facility		$107.15	$107.15	$467.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $181.97 / $389.05	Professional		$117.49	$181.97	$389.05
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $831.76 / $1,288.25	Facility		$309.03	$831.76	$1,288.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $190.55 / $389.05	Professional		$123.03	$190.55	$389.05
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 $134.90 / $194.98 / $281.84	Professional		$134.90	$194.98	$281.84
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 $104.71 / $177.83 / $338.84	Professional		$104.71	$177.83	$338.84