Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $724.44 / $724.44	Facility		$724.44	$724.44	$724.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $812.83 / $1,071.52	Professional		$676.08	$812.83	$1,071.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,023.29 / $1,659.59	Professional		$977.24	$1,023.29	$1,659.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $123.03 / $1,445.44	Facility		$67.61	$123.03	$1,445.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $123.03 / $1,445.44	Professional		$87.10	$123.03	$1,445.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $954.99	Facility		$831.76	$831.76	$954.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $707.95 / $1,348.96	Professional		$707.95	$707.95	$1,348.96
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $1,348.96	Facility		$831.76	$831.76	$1,348.96
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $707.95 / $831.76	Professional		$117.49	$707.95	$831.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $812.83 / $1,288.25	Professional		$512.86	$812.83	$1,288.25
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,412.54 / $2,344.23	Professional		$1,174.90	$1,412.54	$2,344.23
United Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $537.03 / $1,000.00	Facility		$66.07	$537.03	$1,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $676.08 / $1,023.29	Professional		$446.68	$676.08	$1,023.29