Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $512.86 / $758.58	Facility		$251.19	$512.86	$758.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $245.47 / $489.78	Professional		$199.53	$245.47	$489.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $316.23 / $549.54	Facility		$275.42	$316.23	$549.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $147.91 / $389.05	Professional		$120.23	$147.91	$389.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $346.74 / $346.74	Facility		$346.74	$346.74	$346.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $407.38 / $407.38	Professional		$407.38	$407.38	$407.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $1,023.29	Facility		$194.98	$194.98	$1,023.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $257.04 / $575.44	Professional		$138.04	$257.04	$575.44
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $309.03 / $1,023.29	Facility		$199.53	$309.03	$1,023.29
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $162.18 / $575.44	Professional		$138.04	$162.18	$575.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $269.15 / $371.54	Professional		$223.87	$269.15	$371.54
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $363.08 / $363.08	Facility		$363.08	$363.08	$363.08
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $371.54 / $691.83	Professional		$257.04	$371.54	$691.83
United Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $269.15 / $302.00	Facility		$107.15	$269.15	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $181.97 / $346.74	Professional		$125.89	$181.97	$346.74