Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $851.14 / $954.99	Facility		$537.03	$851.14	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $537.03 / $851.14	Professional		$457.09	$537.03	$851.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,071.52 / $2,187.76	Facility		$1,023.29	$1,071.52	$2,187.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $602.56 / $1,288.25	Professional		$489.78	$602.56	$1,288.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $758.58 / $1,202.26	Facility		$501.19	$758.58	$1,202.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $912.01 / $1,348.96	Professional		$645.65	$912.01	$1,348.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $630.96 / $630.96	Facility		$630.96	$630.96	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $630.96	Professional		$457.09	$457.09	$630.96
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $630.96 / $1,479.11	Facility		$630.96	$630.96	$1,479.11
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $630.96	Professional		$457.09	$457.09	$630.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $616.60 / $870.96	Professional		$436.52	$616.60	$870.96
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,230.27	Facility		$1,230.27	$1,230.27	$1,230.27
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,148.15 / $2,089.30	Professional		$1,023.29	$1,148.15	$2,089.30
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $562.34 / $1,148.15	Facility		$416.87	$562.34	$1,148.15
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $501.19 / $758.58	Professional		$331.13	$501.19	$758.58