Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Facility		$302.00	$302.00	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $338.84 / $537.03	Professional		$234.42	$338.84	$537.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $371.54	Professional		$204.17	$204.17	$371.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $426.58 / $707.95	Professional		$416.87	$426.58	$707.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $52.48 / $602.56	Facility		$28.18	$52.48	$602.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $50.12 / $602.56	Professional		$36.31	$50.12	$602.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $389.05	Facility		$281.84	$281.84	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $562.34	Professional		$239.88	$239.88	$562.34
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $562.34	Facility		$281.84	$281.84	$562.34
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $38.02 / $371.54	Professional		$33.11	$38.02	$371.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $380.19 / $602.56	Professional		$239.88	$380.19	$602.56
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $588.84 / $977.24	Professional		$58.88	$588.84	$977.24
United Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $229.09 / $416.87	Facility		$28.18	$229.09	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $281.84 / $436.52	Professional		$186.21	$281.84	$436.52