Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $269.15 / $389.05	Facility		$141.25	$269.15	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $144.54 / $288.40	Professional		$117.49	$144.54	$288.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $186.21 / $323.59	Facility		$162.18	$186.21	$323.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $89.13 / $245.47	Professional		$70.79	$89.13	$245.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $199.53	Facility		$162.18	$162.18	$199.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Professional		$234.42	$234.42	$234.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $602.56	Facility		$114.82	$114.82	$602.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $128.82 / $316.23	Professional		$79.43	$128.82	$316.23
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $181.97 / $724.44	Facility		$117.49	$181.97	$724.44
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $102.33 / $316.23	Professional		$79.43	$102.33	$316.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $158.49 / $218.78	Professional		$131.83	$158.49	$218.78
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Facility		$208.93	$208.93	$208.93
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $213.80 / $407.38	Professional		$147.91	$213.80	$407.38
United Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $158.49 / $173.78	Facility		$63.10	$158.49	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $104.71 / $199.53	Professional		$74.13	$104.71	$199.53