Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $812.83 / $1,318.26	Facility		$426.58	$812.83	$1,318.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $426.58 / $660.69	Professional		$323.59	$426.58	$660.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $562.34 / $977.24	Facility		$489.78	$562.34	$977.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $269.15 / $691.83	Professional		$208.93	$269.15	$691.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $602.56 / $602.56	Facility		$602.56	$602.56	$602.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $707.95 / $707.95	Professional		$707.95	$707.95	$707.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $346.74 / $1,819.70	Facility		$346.74	$346.74	$1,819.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $478.63 / $1,047.13	Professional		$239.88	$478.63	$1,047.13
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $549.54 / $1,819.70	Facility		$354.81	$549.54	$1,819.70
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $281.84 / $1,174.90	Professional		$239.88	$281.84	$1,174.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $478.63 / $660.69	Professional		$398.11	$478.63	$660.69
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $630.96 / $630.96	Facility		$630.96	$630.96	$630.96
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $575.44 / $1,230.27	Professional		$446.68	$575.44	$1,230.27
United Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $478.63 / $524.81	Facility		$190.55	$478.63	$524.81
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $316.23 / $602.56	Professional		$223.87	$316.23	$602.56