Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $275.42 / $407.38	Facility		$128.82	$275.42	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $134.90 / $165.96	Professional		$128.82	$134.90	$165.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $0.02 / $0.02 / $0.07	Facility		$0.02	$0.02	$0.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $158.49 / $251.19	Professional		$138.04	$158.49	$251.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Facility		$138.04	$138.04	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $218.78	Professional		$138.04	$138.04	$218.78
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Facility		$138.04	$138.04	$138.04
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $218.78	Professional		$138.04	$138.04	$218.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $371.54 / $426.58	Professional		$295.12	$371.54	$426.58
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Professional		$60.26	$60.26	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $354.81	Professional		$331.13	$331.13	$354.81