Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $407.38 / $660.69	Facility		$213.80	$407.38	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $213.80 / $478.63	Professional		$169.82	$213.80	$478.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $281.84 / $489.78	Facility		$239.88	$281.84	$489.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $134.90 / $346.74	Professional		$104.71	$134.90	$346.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Facility		$302.00	$302.00	$302.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $354.81 / $354.81	Professional		$354.81	$354.81	$354.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $912.01	Facility		$173.78	$173.78	$912.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $194.98 / $478.63	Professional		$112.20	$194.98	$478.63
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $302.00 / $1,047.13	Facility		$199.53	$302.00	$1,047.13
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $173.78 / $478.63	Professional		$112.20	$173.78	$478.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $239.88 / $323.59	Professional		$199.53	$239.88	$323.59
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Facility		$316.23	$316.23	$316.23
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $323.59 / $616.60	Professional		$223.87	$323.59	$616.60
United Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $194.98 / $239.88	Facility		$95.50	$194.98	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $245.47 / $354.81	Professional		$147.91	$245.47	$354.81