Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $158.49 / $426.58	Facility		$141.25	$158.49	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $204.17	Professional		$141.25	$141.25	$204.17
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $0.02 / $0.02 / $0.07	Facility		$0.02	$0.02	$0.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $158.49 / $229.09	Professional		$141.25	$158.49	$229.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $223.87	Facility		$173.78	$173.78	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $251.19	Professional		$234.42	$234.42	$251.19
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $251.19	Professional		$234.42	$234.42	$251.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $245.47 / $288.40	Professional		$190.55	$245.47	$288.40
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Professional		$60.26	$60.26	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $158.49 / $190.55	Professional		$154.88	$158.49	$190.55