Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $257.04 / $316.23	Facility		$131.83	$257.04	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $177.83 / $295.12	Professional		$131.83	$177.83	$295.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $269.15 / $549.54	Facility		$257.04	$269.15	$549.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $269.15 / $436.52	Professional		$213.80	$269.15	$436.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $218.78 / $354.81	Facility		$147.91	$218.78	$354.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $263.03 / $398.11	Professional		$190.55	$263.03	$398.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Facility		$309.03	$309.03	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $309.03	Professional		$229.09	$229.09	$309.03
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Facility		$309.03	$309.03	$309.03
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $309.03	Professional		$229.09	$229.09	$309.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $275.42 / $398.11	Professional		$194.98	$275.42	$398.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $467.74 / $891.25	Professional		$380.19	$467.74	$891.25
United Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $213.80 / $446.68	Facility		$165.96	$213.80	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $213.80 / $331.13	Professional		$141.25	$213.80	$331.13