Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $954.99 / $954.99	Facility		$954.99	$954.99	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,071.52 / $1,445.44	Professional		$891.25	$1,071.52	$1,445.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,412.54 / $3,235.94	Professional		$1,348.96	$1,412.54	$3,235.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $263.03 / $1,071.52	Facility		$147.91	$263.03	$1,071.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $204.17 / $1,905.46	Professional		$117.49	$204.17	$1,905.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $1,258.93	Facility		$501.19	$501.19	$1,258.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $1,819.70	Professional		$426.58	$426.58	$1,819.70
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $1,819.70	Facility		$501.19	$501.19	$1,819.70
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $426.58 / $501.19	Professional		$154.88	$426.58	$501.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,122.02 / $1,778.28	Professional		$724.44	$1,122.02	$1,778.28
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $1,905.46 / $3,162.28	Professional		$1,621.81	$1,905.46	$3,162.28
United Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $977.24 / $1,584.89	Facility		$128.82	$977.24	$1,584.89
United Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $1,148.15 / $1,862.09	Professional		$602.56	$1,148.15	$1,862.09