Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $478.63 / $812.83	Facility		$257.04	$478.63	$812.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $263.03 / $407.38	Professional		$218.78	$263.03	$407.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $338.84 / $602.56	Facility		$295.12	$338.84	$602.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $162.18 / $426.58	Professional		$128.82	$162.18	$426.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $371.54 / $457.09	Facility		$257.04	$371.54	$457.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $436.52	Professional		$323.59	$323.59	$436.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $1,096.48	Facility		$208.93	$208.93	$1,096.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $295.12 / $645.65	Professional		$147.91	$295.12	$645.65
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $331.13 / $1,096.48	Facility		$288.40	$331.13	$1,096.48
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $186.21 / $724.44	Professional		$147.91	$186.21	$724.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $295.12 / $398.11	Professional		$245.47	$295.12	$398.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Facility		$389.05	$389.05	$389.05
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $354.81 / $758.58	Professional		$275.42	$354.81	$758.58
United Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $295.12 / $323.59	Facility		$117.49	$295.12	$323.59
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $194.98 / $371.54	Professional		$134.90	$194.98	$371.54