Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $389.05 / $23,442.29	Facility		$173.78	$389.05	$23,442.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $288.40	Professional		$173.78	$173.78	$288.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $281.84 / $616.60	Facility		$186.21	$281.84	$616.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $194.98 / $295.12	Professional		$173.78	$194.98	$295.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $257.04	Facility		$173.78	$173.78	$257.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $398.11	Professional		$173.78	$173.78	$398.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $251.19	Facility		$162.18	$162.18	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $218.78	Professional		$173.78	$173.78	$218.78
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $173.78 / $363.08	Facility		$162.18	$173.78	$363.08
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $245.47	Professional		$173.78	$173.78	$245.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $190.55 / $251.19	Professional		$173.78	$190.55	$251.19
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $194.98 / $331.13	Professional		$162.18	$194.98	$331.13
United Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $173.78 / $194.98	Professional		$165.96	$173.78	$194.98