Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $316.23 / $446.68	Facility		$288.40	$316.23	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $316.23 / $416.87	Professional		$269.15	$316.23	$416.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $323.59 / $549.54	Professional		$275.42	$323.59	$549.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $52.48 / $524.81	Facility		$26.30	$52.48	$524.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $70.79 / $630.96	Professional		$33.88	$70.79	$630.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $338.84 / $467.74	Facility		$338.84	$338.84	$467.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $467.74	Professional		$288.40	$288.40	$467.74
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $338.84 / $467.74	Facility		$223.87	$338.84	$467.74
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $288.40 / $338.84	Professional		$46.77	$288.40	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $109.65 / $707.95	Professional		$40.74	$109.65	$707.95
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $691.83 / $1,318.26	Professional		$478.63	$691.83	$1,318.26
United Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $181.97 / $316.23	Facility		$26.92	$181.97	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $213.80 / $331.13	Professional		$123.03	$213.80	$331.13