Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $416.87 / $691.83	Facility		$223.87	$416.87	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $229.09 / $676.08	Professional		$138.04	$229.09	$676.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $295.12 / $512.86	Facility		$257.04	$295.12	$512.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $134.90 / $354.81	Professional		$112.20	$134.90	$354.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $323.59 / $389.05	Facility		$223.87	$323.59	$389.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $331.13 / $380.19	Professional		$281.84	$331.13	$380.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $954.99	Facility		$181.97	$181.97	$954.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $199.53 / $630.96	Professional		$125.89	$199.53	$630.96
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $288.40 / $954.99	Facility		$186.21	$288.40	$954.99
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $151.36 / $630.96	Professional		$125.89	$151.36	$630.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $251.19 / $346.74	Professional		$208.93	$251.19	$346.74
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $331.13 / $331.13	Facility		$331.13	$331.13	$331.13
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $309.03 / $645.65	Professional		$239.88	$309.03	$645.65
United Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $251.19 / $281.84	Facility		$77.62	$251.19	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $147.91 / $323.59	Professional		$58.88	$147.91	$323.59