Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $91.20 / $251.19	Facility		$74.13	$91.20	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $79.43 / $112.20	Professional		$60.26	$79.43	$112.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $151.36 / $302.00	Facility		$141.25	$151.36	$302.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $81.28 / $181.97	Professional		$67.61	$81.28	$181.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $138.04 / $223.87	Facility		$93.33	$138.04	$223.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $165.96 / $251.19	Professional		$120.23	$165.96	$251.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $91.20	Professional		$66.07	$66.07	$91.20
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $251.19	Facility		$91.20	$91.20	$251.19
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $91.20	Professional		$66.07	$66.07	$91.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $85.11 / $123.03	Professional		$60.26	$85.11	$123.03
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $158.49 / $295.12	Professional		$141.25	$158.49	$295.12
United Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $74.13 / $162.18	Facility		$53.70	$74.13	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $69.18 / $104.71	Professional		$46.77	$69.18	$104.71