Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $501.19 / $741.31	Facility		$263.03	$501.19	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $269.15 / $549.54	Professional		$218.78	$269.15	$549.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $346.74 / $602.56	Facility		$302.00	$346.74	$602.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $169.82 / $446.68	Professional		$131.83	$169.82	$446.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $380.19 / $380.19	Facility		$380.19	$380.19	$380.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Professional		$446.68	$446.68	$446.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $1,122.02	Facility		$213.80	$213.80	$1,122.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $257.04 / $588.84	Professional		$151.36	$257.04	$588.84
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $338.84 / $1,348.96	Facility		$218.78	$338.84	$1,348.96
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $245.47 / $588.84	Professional		$151.36	$245.47	$588.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $295.12 / $407.38	Professional		$245.47	$295.12	$407.38
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Facility		$398.11	$398.11	$398.11
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $407.38 / $758.58	Professional		$281.84	$407.38	$758.58
United Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $295.12 / $331.13	Facility		$117.49	$295.12	$331.13
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $199.53 / $380.19	Professional		$138.04	$199.53	$380.19