Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $199.53 / $269.15	Facility		$154.88	$199.53	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $144.54 / $208.93	Professional		$112.20	$144.54	$208.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $309.03 / $630.96	Facility		$295.12	$309.03	$630.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $165.96 / $371.54	Professional		$141.25	$165.96	$371.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $186.21 / $302.00	Facility		$125.89	$186.21	$302.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $223.87 / $338.84	Professional		$162.18	$223.87	$338.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Facility		$186.21	$186.21	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $186.21	Professional		$134.90	$134.90	$186.21
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $363.08	Facility		$186.21	$186.21	$363.08
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $186.21	Professional		$134.90	$134.90	$186.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $173.78 / $251.19	Professional		$125.89	$173.78	$251.19
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $354.81 / $354.81	Facility		$354.81	$354.81	$354.81
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $331.13 / $602.56	Professional		$295.12	$331.13	$602.56
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $138.04 / $288.40	Facility		$104.71	$138.04	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $134.90 / $199.53	Professional		$93.33	$134.90	$199.53