Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $389.05 / $1,023.29	Facility		$162.18	$389.05	$1,023.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $223.87 / $489.78	Professional		$173.78	$223.87	$489.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $288.40 / $501.19	Facility		$251.19	$288.40	$501.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $138.04 / $371.54	Professional		$109.65	$138.04	$371.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $316.23 / $389.05	Facility		$218.78	$316.23	$389.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $331.13 / $371.54	Professional		$275.42	$331.13	$371.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $1,584.89	Facility		$177.83	$177.83	$1,584.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $239.88 / $549.54	Professional		$125.89	$239.88	$549.54
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $281.84 / $1,584.89	Facility		$245.47	$281.84	$1,584.89
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $147.91 / $616.60	Professional		$125.89	$147.91	$616.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $245.47 / $338.84	Professional		$204.17	$245.47	$338.84
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $331.13 / $331.13	Facility		$331.13	$331.13	$331.13
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $302.00 / $630.96	Professional		$234.42	$302.00	$630.96
United Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $245.47 / $275.42	Facility		$100.00	$245.47	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $165.96 / $316.23	Professional		$114.82	$165.96	$316.23