Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $107.15 / $131.83	Facility		$74.13	$107.15	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $74.13 / $114.82	Professional		$60.26	$74.13	$114.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $147.91 / $302.00	Facility		$141.25	$147.91	$302.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $85.11 / $177.83	Professional		$67.61	$85.11	$177.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $104.71 / $165.96	Facility		$69.18	$104.71	$165.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $125.89 / $186.21	Professional		$89.13	$125.89	$186.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $89.13	Professional		$66.07	$66.07	$89.13
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $190.55	Facility		$89.13	$89.13	$190.55
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $89.13	Professional		$66.07	$66.07	$89.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $85.11 / $120.23	Professional		$60.26	$85.11	$120.23
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 / $288.40	Professional		$141.25	$158.49	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $77.62 / $158.49	Facility		$57.54	$77.62	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $69.18 / $104.71	Professional		$45.71	$69.18	$104.71