Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $213.80 / $223.87	Facility		$120.23	$213.80	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $117.49 / $181.97	Professional		$95.50	$117.49	$181.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $245.47 / $489.78	Facility		$229.09	$245.47	$489.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $131.83 / $295.12	Professional		$109.65	$131.83	$295.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $162.18 / $263.03	Facility		$109.65	$162.18	$263.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $194.98 / $295.12	Professional		$141.25	$194.98	$295.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $134.90	Professional		$100.00	$100.00	$134.90
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $295.12	Facility		$134.90	$134.90	$295.12
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $134.90	Professional		$100.00	$100.00	$134.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $138.04 / $199.53	Professional		$97.72	$138.04	$199.53
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Facility		$275.42	$275.42	$275.42
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $257.04 / $478.63	Professional		$229.09	$257.04	$478.63
United Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $117.49 / $251.19	Facility		$83.18	$117.49	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $107.15 / $165.96	Professional		$75.86	$107.15	$165.96