Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $457.09 / $676.08	Facility		$239.88	$457.09	$676.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $245.47 / $501.19	Professional		$199.53	$245.47	$501.19
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 / $154.88 / $416.87	Professional		$120.23	$154.88	$416.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $346.74	Facility		$281.84	$281.84	$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 / $223.87 / $537.03	Professional		$138.04	$223.87	$537.03
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $309.03 / $1,230.27	Facility		$199.53	$309.03	$1,230.27
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $177.83 / $537.03	Professional		$138.04	$177.83	$537.03
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 $109.65 / $269.15 / $302.00	Facility		$109.65	$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