Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $323.59 / $398.11	Facility		$223.87	$323.59	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $218.78 / $323.59	Professional		$165.96	$218.78	$323.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $446.68 / $912.01	Facility		$426.58	$446.68	$912.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $234.42 / $537.03	Professional		$204.17	$234.42	$537.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $316.23 / $501.19	Facility		$208.93	$316.23	$501.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $380.19 / $562.34	Professional		$275.42	$380.19	$562.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Facility		$234.42	$234.42	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $234.42	Professional		$169.82	$169.82	$234.42
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $575.44	Facility		$234.42	$234.42	$575.44
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $234.42	Professional		$169.82	$169.82	$234.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $223.87 / $323.59	Professional		$158.49	$223.87	$323.59
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $512.86 / $512.86	Facility		$512.86	$512.86	$512.86
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $478.63 / $870.96	Professional		$426.58	$478.63	$870.96
United Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $199.53 / $436.52	Facility		$144.54	$199.53	$436.52
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $199.53 / $281.84	Professional		$138.04	$199.53	$281.84