Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $229.09 / $371.54	Facility		$117.49	$229.09	$371.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $138.04 / $302.00	Professional		$112.20	$138.04	$302.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $154.88 / $275.42	Facility		$134.90	$154.88	$275.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $93.33 / $190.55	Professional		$74.13	$93.33	$190.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $169.82	Facility		$100.00	$100.00	$169.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Professional		$199.53	$199.53	$199.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $562.34	Facility		$95.50	$95.50	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $85.11 / $213.80	Professional		$75.86	$85.11	$213.80
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $151.36 / $562.34	Facility		$95.50	$151.36	$562.34
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $85.11 / $204.17	Professional		$75.86	$85.11	$204.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $123.03 / $181.97	Professional		$100.00	$123.03	$181.97
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Facility		$177.83	$177.83	$177.83
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $154.88 / $346.74	Professional		$95.50	$154.88	$346.74
United Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $102.33 / $147.91	Facility		$53.70	$102.33	$147.91
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $89.13 / $177.83	Professional		$61.66	$89.13	$177.83