Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $263.03 / $398.11	Facility		$141.25	$263.03	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $144.54 / $371.54	Professional		$134.90	$144.54	$371.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $186.21 / $323.59	Facility		$162.18	$186.21	$323.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $109.65 / $239.88	Professional		$87.10	$109.65	$239.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Professional		$239.88	$239.88	$239.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $676.08	Facility		$114.82	$114.82	$676.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $158.49 / $416.87	Professional		$89.13	$158.49	$416.87
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $181.97 / $676.08	Facility		$158.49	$181.97	$676.08
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $134.90 / $436.52	Professional		$89.13	$134.90	$436.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $158.49 / $218.78	Professional		$131.83	$158.49	$218.78
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Facility		$213.80	$213.80	$213.80
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $194.98 / $407.38	Professional		$151.36	$194.98	$407.38
United Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $158.49 / $177.83	Facility		$63.10	$158.49	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $107.15 / $239.88	Professional		$74.13	$107.15	$239.88