Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $380.19 / $398.11	Facility		$213.80	$380.19	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $213.80 / $323.59	Professional		$181.97	$213.80	$323.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $436.52 / $870.96	Facility		$407.38	$436.52	$870.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $234.42 / $524.81	Professional		$194.98	$234.42	$524.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $302.00 / $478.63	Facility		$199.53	$302.00	$478.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $363.08 / $537.03	Professional		$263.03	$363.08	$537.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $251.19 / $251.19	Facility		$251.19	$251.19	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $251.19	Professional		$181.97	$181.97	$251.19
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $251.19 / $562.34	Facility		$251.19	$251.19	$562.34
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $251.19	Professional		$181.97	$181.97	$251.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $245.47 / $354.81	Professional		$173.78	$245.47	$354.81
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Facility		$489.78	$489.78	$489.78
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $457.09 / $851.14	Professional		$407.38	$457.09	$851.14
United Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $223.87 / $467.74	Facility		$165.96	$223.87	$467.74
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $199.53 / $302.00	Professional		$134.90	$199.53	$302.00