Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $758.58 / $1,096.48	Facility		$354.81	$758.58	$1,096.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $363.08 / $446.68	Professional		$354.81	$363.08	$446.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $794.33 / $2,398.83	Facility		$398.11	$794.33	$2,398.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $14.45 / $371.54	Professional		$11.22	$14.45	$371.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6.17 / $6.17 / $6.17	Facility		$6.17	$6.17	$6.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $371.54 / $371.54	Facility		$371.54	$371.54	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $371.54 / $436.52	Professional		$371.54	$371.54	$436.52
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $371.54 / $371.54	Facility		$371.54	$371.54	$371.54
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $371.54 / $436.52	Professional		$371.54	$371.54	$436.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $63.10 / $75.86	Professional		$50.12	$63.10	$75.86
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $588.84 / $1,000.00	Professional		$426.58	$588.84	$1,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $398.11 / $436.52	Professional		$371.54	$398.11	$436.52