Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $912.01 / $1,584.89	Facility		$812.83	$912.01	$1,584.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $933.25 / $1,318.26	Professional		$794.33	$933.25	$1,318.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,071.52 / $1,778.28	Professional		$776.25	$1,071.52	$1,778.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $660.69 / $776.25	Facility		$114.82	$660.69	$776.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $1,318.26	Facility		$1,318.26	$1,318.26	$1,318.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,174.90 / $2,041.74	Professional		$812.83	$1,174.90	$2,041.74
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,288.25	Facility		$1,288.25	$1,288.25	$1,288.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,148.15 / $1,778.28	Professional		$794.33	$1,148.15	$1,778.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $67.61	Professional		$32.36	$33.11	$67.61
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,148.15	Facility		$1,148.15	$1,148.15	$1,148.15
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,174.90 / $2,089.30	Professional		$954.99	$1,174.90	$2,089.30
United Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $1,047.13 / $2,238.72	Facility		$131.83	$1,047.13	$2,238.72
United Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,122.02 / $1,949.84	Professional		$851.14	$1,122.02	$1,949.84