Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $199.53 / $870.96	Facility		$69.18	$199.53	$870.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $69.18 / $112.20	Professional		$54.95	$69.18	$112.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $138.04 / $281.84	Facility		$131.83	$138.04	$281.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $75.86 / $165.96	Professional		$63.10	$75.86	$165.96
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Professional		$109.65	$109.65	$109.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $104.71 / $169.82	Facility		$70.79	$104.71	$169.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $125.89 / $190.55	Professional		$91.20	$125.89	$190.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $100.00	Facility		$77.62	$77.62	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $77.62	Professional		$56.23	$56.23	$77.62
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $263.03	Facility		$77.62	$77.62	$263.03
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $77.62	Professional		$56.23	$56.23	$77.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $112.20 / $162.18	Professional		$72.44	$112.20	$162.18
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Facility		$158.49	$158.49	$158.49
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $147.91 / $269.15	Professional		$131.83	$147.91	$269.15
United Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $66.07 / $141.25	Facility		$50.12	$66.07	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $61.66 / $93.33	Professional		$42.66	$61.66	$93.33