Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $912.01 / $1,348.96	Facility		$478.63	$912.01	$1,348.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $489.78 / $912.01	Professional		$323.59	$489.78	$912.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $630.96 / $1,096.48	Facility		$549.54	$630.96	$1,096.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $309.03 / $812.83	Professional		$239.88	$309.03	$812.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Facility		$691.83	$691.83	$691.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $812.83 / $812.83	Professional		$812.83	$812.83	$812.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $2,041.74	Facility		$389.05	$389.05	$2,041.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $501.19 / $1,071.52	Professional		$275.42	$501.19	$1,071.52
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $616.60 / $2,454.71	Facility		$398.11	$616.60	$2,454.71
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $446.68 / $1,071.52	Professional		$275.42	$446.68	$1,071.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $537.03 / $741.31	Professional		$446.68	$537.03	$741.31
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $724.44 / $724.44	Facility		$724.44	$724.44	$724.44
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $741.31 / $1,380.38	Professional		$512.86	$741.31	$1,380.38
United Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $537.03 / $602.56	Facility		$213.80	$537.03	$602.56
United Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $363.08 / $691.83	Professional		$251.19	$363.08	$691.83