Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $186.21 / $309.03	Facility		$100.00	$186.21	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $104.71 / $346.74	Professional		$81.28	$104.71	$346.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $131.83 / $229.09	Facility		$114.82	$131.83	$229.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $61.66 / $169.82	Professional		$50.12	$61.66	$169.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Facility		$144.54	$144.54	$144.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Professional		$169.82	$169.82	$169.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $263.03	Facility		$81.28	$81.28	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $67.61 / $223.87	Professional		$38.02	$67.61	$223.87
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $158.49 / $724.44	Facility		$81.28	$158.49	$724.44
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $64.57 / $223.87	Professional		$38.02	$64.57	$223.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $112.20 / $154.88	Professional		$93.33	$112.20	$154.88
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Facility		$147.91	$147.91	$147.91
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $138.04 / $288.40	Professional		$107.15	$138.04	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $112.20 / $125.89	Facility		$44.67	$112.20	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $69.18 / $144.54	Professional		$34.67	$69.18	$144.54