Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $380.19 / $616.60	Facility		$162.18	$380.19	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $154.88 / $316.23	Professional		$114.82	$154.88	$316.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $181.97 / $316.23	Facility		$158.49	$181.97	$316.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $120.23 / $251.19	Professional		$93.33	$120.23	$251.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Facility		$199.53	$199.53	$199.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Professional		$234.42	$234.42	$234.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $630.96	Facility		$112.20	$112.20	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $154.88 / $398.11	Professional		$85.11	$154.88	$398.11
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $186.21 / $630.96	Facility		$154.88	$186.21	$630.96
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $154.88 / $346.74	Professional		$85.11	$154.88	$346.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $154.88 / $213.80	Professional		$128.82	$154.88	$213.80
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Facility		$208.93	$208.93	$208.93
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $213.80 / $407.38	Professional		$147.91	$213.80	$407.38
United Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $154.88 / $181.97	Facility		$63.10	$154.88	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $173.78 / $275.42	Professional		$104.71	$173.78	$275.42