Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $436.52 / $630.96	Facility		$223.87	$436.52	$630.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $229.09 / $467.74	Professional		$190.55	$229.09	$467.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $295.12 / $524.81	Facility		$257.04	$295.12	$524.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $144.54 / $389.05	Professional		$112.20	$144.54	$389.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $263.03 / $323.59	Facility		$263.03	$263.03	$323.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $380.19 / $380.19	Professional		$380.19	$380.19	$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 $128.82 / $208.93 / $512.86	Professional		$128.82	$208.93	$512.86
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $288.40 / $1,148.15	Facility		$190.55	$288.40	$1,148.15
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $165.96 / $512.86	Professional		$128.82	$165.96	$512.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $257.04 / $346.74	Professional		$213.80	$257.04	$346.74
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Facility		$338.84	$338.84	$338.84
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $346.74 / $660.69	Professional		$239.88	$346.74	$660.69
United Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $257.04 / $281.84	Facility		$102.33	$257.04	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $169.82 / $323.59	Professional		$117.49	$169.82	$323.59