Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $891.25 / $1,288.25	Facility		$467.74	$891.25	$1,288.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $478.63 / $1,000.00	Professional		$407.38	$478.63	$1,000.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $616.60 / $1,071.52	Facility		$537.03	$616.60	$1,071.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $302.00 / $724.44	Professional		$234.42	$302.00	$724.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $524.81 / $660.69	Facility		$524.81	$524.81	$660.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $776.25 / $776.25	Professional		$776.25	$776.25	$776.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $380.19 / $1,995.26	Facility		$380.19	$380.19	$1,995.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $316.23 / $776.25	Professional		$257.04	$316.23	$776.25
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $602.56 / $1,995.26	Facility		$380.19	$602.56	$1,995.26
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $269.15 / $489.78	Professional		$257.04	$269.15	$489.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Professional		$316.23	$316.23	$316.23
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Facility		$691.83	$691.83	$691.83
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $602.56 / $1,348.96	Professional		$380.19	$602.56	$1,348.96
United Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $323.59 / $575.44	Facility		$208.93	$323.59	$575.44
United Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $346.74 / $575.44	Professional		$245.47	$346.74	$575.44