Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $457.09 / $741.31	Facility		$234.42	$457.09	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $239.88 / $371.54	Professional		$199.53	$239.88	$371.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $309.03 / $549.54	Facility		$269.15	$309.03	$549.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $151.36 / $398.11	Professional		$117.49	$151.36	$398.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Facility		$338.84	$338.84	$338.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Professional		$398.11	$398.11	$398.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $1,000.00	Facility		$190.55	$190.55	$1,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $229.09 / $537.03	Professional		$134.90	$229.09	$537.03
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $302.00 / $1,000.00	Facility		$199.53	$302.00	$1,000.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $218.78 / $537.03	Professional		$134.90	$218.78	$537.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $269.15 / $363.08	Professional		$223.87	$269.15	$363.08
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $354.81 / $354.81	Facility		$354.81	$354.81	$354.81
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $363.08 / $691.83	Professional		$251.19	$363.08	$691.83
United Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $269.15 / $295.12	Facility		$107.15	$269.15	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $177.83 / $338.84	Professional		$123.03	$177.83	$338.84