Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $229.09 / $407.38	Facility		$134.90	$229.09	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $138.04 / $213.80	Professional		$100.00	$138.04	$213.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $177.83 / $316.23	Facility		$154.88	$177.83	$316.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $87.10 / $239.88	Professional		$67.61	$87.10	$239.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $194.98 / $239.88	Facility		$134.90	$194.98	$239.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $229.09	Professional		$169.82	$169.82	$229.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $575.44	Facility		$109.65	$109.65	$575.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $147.91 / $338.84	Professional		$60.26	$147.91	$338.84
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $173.78 / $575.44	Facility		$151.36	$173.78	$575.44
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $91.20 / $354.81	Professional		$58.88	$91.20	$354.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $151.36 / $208.93	Professional		$128.82	$151.36	$208.93
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $186.21 / $398.11	Professional		$144.54	$186.21	$398.11
United Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $151.36 / $169.82	Facility		$61.66	$151.36	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $93.33 / $194.98	Professional		$53.70	$93.33	$194.98