Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $446.68 / $776.25	Facility		$208.93	$446.68	$776.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $208.93 / $426.58	Professional		$190.55	$208.93	$426.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $269.15 / $478.63	Facility		$234.42	$269.15	$478.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $162.18 / $354.81	Professional		$125.89	$162.18	$354.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Facility		$295.12	$295.12	$295.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $346.74 / $346.74	Professional		$346.74	$346.74	$346.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $977.24	Facility		$165.96	$165.96	$977.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $234.42 / $501.19	Professional		$131.83	$234.42	$501.19
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $263.03 / $977.24	Facility		$229.09	$263.03	$977.24
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $234.42 / $512.86	Professional		$131.83	$234.42	$512.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $229.09 / $316.23	Professional		$194.98	$229.09	$316.23
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Facility		$309.03	$309.03	$309.03
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $316.23 / $602.56	Professional		$218.78	$316.23	$602.56
United Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $194.98 / $229.09	Facility		$93.33	$194.98	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $154.88 / $354.81	Professional		$107.15	$154.88	$354.81