Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $151.36 / $218.78	Facility		$123.03	$151.36	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $107.15 / $158.49	Professional		$79.43	$107.15	$158.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $245.47 / $501.19	Facility		$234.42	$245.47	$501.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $128.82 / $295.12	Professional		$109.65	$128.82	$295.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $138.04 / $218.78	Facility		$91.20	$138.04	$218.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $165.96 / $245.47	Professional		$117.49	$165.96	$245.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $112.20	Professional		$81.28	$81.28	$112.20
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $245.47	Facility		$112.20	$112.20	$245.47
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $112.20	Professional		$81.28	$81.28	$112.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $144.54 / $204.17	Professional		$102.33	$144.54	$204.17
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Facility		$281.84	$281.84	$281.84
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $263.03 / $478.63	Professional		$234.42	$263.03	$478.63
United Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $100.00 / $208.93	Facility		$74.13	$100.00	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $104.71 / $144.54	Professional		$67.61	$104.71	$144.54