Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $457.09 / $691.83	Facility		$245.47	$457.09	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $331.13	Professional		$245.47	$245.47	$331.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $446.68 / $1,288.25	Facility		$269.15	$446.68	$1,288.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $281.84 / $426.58	Professional		$245.47	$281.84	$426.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Facility		$245.47	$245.47	$245.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $331.13	Professional		$245.47	$245.47	$331.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $346.74	Facility		$234.42	$234.42	$346.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $316.23	Professional		$245.47	$245.47	$316.23
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $245.47 / $602.56	Facility		$234.42	$245.47	$602.56
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $346.74	Professional		$245.47	$245.47	$346.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $269.15 / $354.81	Professional		$245.47	$269.15	$354.81
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $295.12 / $467.74	Professional		$245.47	$295.12	$467.74
United Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Facility		$245.47	$245.47	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $245.47 / $275.42	Professional		$234.42	$245.47	$275.42