Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $239.88 / $323.59	Professional		$204.17	$239.88	$323.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $416.87 / $588.84	Facility		$398.11	$416.87	$588.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $295.12 / $630.96	Professional		$208.93	$295.12	$630.96
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $398.11 / $426.58	Professional		$389.05	$398.11	$426.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $199.53 / $389.05	Facility		$19.95	$199.53	$389.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $251.19 / $363.08	Professional		$26.30	$251.19	$363.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $269.15 / $331.13	Facility		$269.15	$269.15	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $389.05	Professional		$229.09	$229.09	$389.05
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $269.15 / $331.13	Facility		$269.15	$269.15	$331.13
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $269.15 / $389.05	Professional		$229.09	$269.15	$389.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $331.13 / $537.03	Professional		$269.15	$331.13	$537.03
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $407.38 / $676.08	Professional		$338.84	$407.38	$676.08
United Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $154.88 / $288.40	Facility		$19.50	$154.88	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $190.55 / $295.12	Professional		$128.82	$190.55	$295.12