Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $977.24 / $1,621.81	Facility		$537.03	$977.24	$1,621.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $537.03 / $812.83	Professional		$199.53	$537.03	$812.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $707.95 / $1,258.93	Facility		$616.60	$707.95	$1,258.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $138.04 / $851.14	Professional		$112.20	$138.04	$851.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $776.25 / $954.99	Facility		$537.03	$776.25	$954.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $812.83 / $912.01	Professional		$676.08	$812.83	$912.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $436.52 / $1,412.54	Facility		$436.52	$436.52	$1,412.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $602.56 / $1,202.26	Professional		$309.03	$602.56	$1,202.26
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $691.83 / $1,621.81	Facility		$457.09	$691.83	$1,621.81
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $363.08 / $1,202.26	Professional		$309.03	$363.08	$1,202.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $602.56 / $831.76	Professional		$512.86	$602.56	$831.76
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $812.83 / $812.83	Facility		$812.83	$812.83	$812.83
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $707.95 / $1,348.96	Professional		$436.52	$707.95	$1,348.96
United Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $602.56 / $676.08	Facility		$245.47	$602.56	$676.08
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $169.82 / $660.69	Professional		$117.49	$169.82	$660.69