Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $776.25 / $1,096.48	Facility		$363.08	$776.25	$1,096.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $363.08 / $776.25	Professional		$302.00	$363.08	$776.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $426.58 / $741.31	Facility		$371.54	$426.58	$741.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $239.88 / $524.81	Professional		$199.53	$239.88	$524.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Facility		$467.74	$467.74	$467.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $537.03 / $537.03	Professional		$537.03	$537.03	$537.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $263.03 / $1,513.56	Facility		$263.03	$263.03	$1,513.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $363.08 / $954.99	Professional		$204.17	$363.08	$954.99
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $416.87 / $1,513.56	Facility		$354.81	$416.87	$1,513.56
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $309.03 / $1,000.00	Professional		$204.17	$309.03	$1,000.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $363.08 / $501.19	Professional		$302.00	$363.08	$501.19
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Facility		$478.63	$478.63	$478.63
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $446.68 / $933.25	Professional		$338.84	$446.68	$933.25
United Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $363.08 / $398.11	Facility		$144.54	$363.08	$398.11
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $239.88 / $549.54	Professional		$169.82	$239.88	$549.54