Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $181.97 / $489.78	Facility		$162.18	$181.97	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $239.88	Professional		$162.18	$162.18	$239.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $354.81 / $1,071.52	Facility		$177.83	$354.81	$1,071.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $194.98 / $331.13	Professional		$173.78	$194.98	$331.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Professional		$218.78	$218.78	$218.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $204.17	Facility		$154.88	$154.88	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $288.40	Professional		$204.17	$204.17	$288.40
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $204.17	Facility		$154.88	$154.88	$204.17
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $288.40	Professional		$204.17	$204.17	$288.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $181.97 / $229.09	Professional		$162.18	$181.97	$229.09
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $229.09 / $446.68	Professional		$208.93	$229.09	$446.68
United Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $194.98	Facility		$186.21	$186.21	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $194.98 / $218.78	Professional		$158.49	$194.98	$218.78