Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $478.63 / $870.96	Facility		$263.03	$478.63	$870.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $245.47 / $354.81	Professional		$169.82	$245.47	$354.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $524.81 / $1,071.52	Facility		$501.19	$524.81	$1,071.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $281.84 / $630.96	Professional		$239.88	$281.84	$630.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $309.03 / $501.19	Facility		$208.93	$309.03	$501.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $371.54 / $562.34	Professional		$269.15	$371.54	$562.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Facility		$275.42	$275.42	$275.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $275.42	Professional		$199.53	$199.53	$275.42
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $562.34	Facility		$275.42	$275.42	$562.34
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $275.42	Professional		$199.53	$199.53	$275.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $295.12 / $426.58	Professional		$213.80	$295.12	$426.58
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $588.84 / $588.84	Facility		$588.84	$588.84	$588.84
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $549.54 / $1,023.29	Professional		$501.19	$549.54	$1,023.29
United Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $223.87 / $478.63	Facility		$173.78	$223.87	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $223.87 / $316.23	Professional		$154.88	$223.87	$316.23