Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $776.25 / $977.24	Facility		$380.19	$776.25	$977.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $316.23 / $380.19	Professional		$309.03	$316.23	$380.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $691.83 / $2,089.30	Facility		$346.74	$691.83	$2,089.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $363.08 / $549.54	Professional		$302.00	$363.08	$549.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $323.59	Professional		$323.59	$323.59	$323.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $323.59 / $616.60	Facility		$323.59	$323.59	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $380.19	Professional		$323.59	$323.59	$380.19
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $323.59 / $363.08	Facility		$323.59	$323.59	$363.08
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $380.19	Professional		$323.59	$323.59	$380.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $50.12 / $60.26	Professional		$39.81	$50.12	$60.26
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $380.19 / $794.33	Professional		$338.84	$380.19	$794.33
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $323.59 / $331.13	Professional		$302.00	$323.59	$331.13