Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $389.05 / $549.54	Facility		$194.98	$389.05	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $263.03	Professional		$194.98	$194.98	$263.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $363.08 / $1,023.29	Facility		$213.80	$363.08	$1,023.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $223.87 / $338.84	Professional		$194.98	$223.87	$338.84
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Facility		$467.74	$467.74	$467.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $257.04	Professional		$190.55	$190.55	$257.04
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 / $251.19	Professional		$194.98	$194.98	$251.19
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $194.98 / $251.19	Facility		$181.97	$194.98	$251.19
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $275.42	Professional		$194.98	$194.98	$275.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $213.80 / $275.42	Professional		$190.55	$213.80	$275.42
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $223.87 / $371.54	Professional		$194.98	$223.87	$371.54
United Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $194.98 / $194.98	Facility		$190.55	$194.98	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $194.98 / $218.78	Professional		$186.21	$194.98	$218.78