Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $630.96 / $933.25	Facility		$295.12	$630.96	$933.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $309.03 / $380.19	Professional		$295.12	$309.03	$380.19
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 $323.59 / $363.08 / $549.54	Professional		$323.59	$363.08	$549.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $114.82 / $138.04	Facility		$100.00	$114.82	$138.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $114.82 / $114.82	Professional		$11.48	$114.82	$114.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $323.59 / $323.59	Facility		$204.17	$323.59	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $407.38	Professional		$323.59	$323.59	$407.38
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $323.59 / $323.59	Facility		$158.49	$323.59	$323.59
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $457.09	Professional		$323.59	$323.59	$457.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $354.81 / $467.74	Professional		$323.59	$354.81	$467.74
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $70.79 / $812.83	Professional		$50.12	$70.79	$812.83
United Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $309.03 / $346.74	Professional		$295.12	$309.03	$346.74