Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Facility		$416.87	$416.87	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $478.63 / $602.56	Professional		$389.05	$478.63	$602.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $851.14 / $1,202.26	Facility		$794.33	$851.14	$1,202.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $562.34 / $1,174.90	Professional		$398.11	$562.34	$1,174.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $371.54 / $741.31	Facility		$43.65	$371.54	$741.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $426.58 / $676.08	Professional		$56.23	$426.58	$676.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $707.95	Facility		$275.42	$275.42	$707.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $234.42 / $676.08	Professional		$204.17	$234.42	$676.08
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $707.95	Facility		$275.42	$275.42	$707.95
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $234.42 / $676.08	Professional		$204.17	$234.42	$676.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $616.60 / $977.24	Professional		$489.78	$616.60	$977.24
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $870.96 / $1,445.44	Professional		$741.31	$870.96	$1,445.44
United Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $295.12 / $549.54	Facility		$37.15	$295.12	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $389.05 / $562.34	Professional		$257.04	$389.05	$562.34