Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $407.38 / $501.19	Facility		$281.84	$407.38	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $281.84 / $436.52	Professional		$234.42	$281.84	$436.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $562.34 / $1,148.15	Facility		$537.03	$562.34	$1,148.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $323.59 / $676.08	Professional		$257.04	$323.59	$676.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $512.86 / $812.83	Facility		$338.84	$512.86	$812.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $616.60 / $912.01	Professional		$436.52	$616.60	$912.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $371.54 / $371.54	Facility		$371.54	$371.54	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $371.54	Professional		$275.42	$275.42	$371.54
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $371.54 / $912.01	Facility		$371.54	$371.54	$912.01
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $346.74	Professional		$275.42	$275.42	$346.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $316.23 / $457.09	Professional		$229.09	$316.23	$457.09
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $645.65	Facility		$645.65	$645.65	$645.65
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $602.56 / $1,096.48	Professional		$537.03	$602.56	$1,096.48
United Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $288.40 / $602.56	Facility		$218.78	$288.40	$602.56
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $263.03 / $389.05	Professional		$173.78	$263.03	$389.05