Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Facility		$213.80	$213.80	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $213.80 / $229.09	Professional		$199.53	$213.80	$229.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $407.38 / $575.44	Facility		$380.19	$407.38	$575.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $218.78 / $645.65	Professional		$181.97	$218.78	$645.65
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $257.04 / $275.42	Professional		$245.47	$257.04	$275.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $208.93 / $389.05	Facility		$151.36	$208.93	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $213.80 / $251.19	Professional		$208.93	$213.80	$251.19
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $208.93 / $1,778.28	Facility		$151.36	$208.93	$1,778.28
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $208.93 / $288.40	Professional		$204.17	$208.93	$288.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $354.81	Professional		$204.17	$204.17	$354.81
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $371.54 / $371.54	Professional		$371.54	$371.54	$371.54
United Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Facility		$275.42	$275.42	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $204.17 / $275.42	Professional		$177.83	$204.17	$275.42