Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $338.84 / $776.25	Facility		$131.83	$338.84	$776.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $131.83 / $309.03	Professional		$112.20	$131.83	$309.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $173.78 / $302.00	Facility		$151.36	$173.78	$302.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $95.50 / $213.80	Professional		$81.28	$95.50	$213.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Professional		$223.87	$223.87	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $1,047.13	Facility		$107.15	$107.15	$1,047.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $147.91 / $389.05	Professional		$83.18	$147.91	$389.05
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $239.88 / $977.24	Facility		$120.23	$239.88	$977.24
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $125.89 / $407.38	Professional		$83.18	$125.89	$407.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $147.91 / $204.17	Professional		$123.03	$147.91	$204.17
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $181.97 / $380.19	Professional		$138.04	$181.97	$380.19
United Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $147.91 / $162.18	Facility		$58.88	$147.91	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $97.72 / $223.87	Professional		$69.18	$97.72	$223.87