Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $338.84 / $549.54	Facility		$194.98	$338.84	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $199.53 / $257.04	Professional		$194.98	$199.53	$257.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $371.54 / $1,288.25	Facility		$213.80	$371.54	$1,288.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $218.78 / $354.81	Professional		$194.98	$218.78	$354.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $263.03	Professional		$263.03	$263.03	$263.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $194.98	Facility		$186.21	$186.21	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $281.84	Professional		$194.98	$194.98	$281.84
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $194.98	Facility		$186.21	$186.21	$194.98
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $281.84	Professional		$194.98	$194.98	$281.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $239.88 / $281.84	Professional		$194.98	$239.88	$281.84
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $331.13 / $457.09	Professional		$199.53	$331.13	$457.09
United Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $208.93	Professional		$194.98	$194.98	$208.93