Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $181.97 / $245.47	Facility		$138.04	$181.97	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $138.04 / $181.97	Professional		$100.00	$138.04	$181.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $275.42 / $562.34	Facility		$263.03	$275.42	$562.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $151.36 / $331.13	Professional		$125.89	$151.36	$331.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $173.78 / $275.42	Facility		$114.82	$173.78	$275.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $208.93 / $309.03	Professional		$151.36	$208.93	$309.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Facility		$165.96	$165.96	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $165.96	Professional		$120.23	$120.23	$165.96
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $316.23	Facility		$165.96	$165.96	$316.23
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $165.96	Professional		$120.23	$120.23	$165.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $158.49 / $223.87	Professional		$112.20	$158.49	$223.87
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Facility		$316.23	$316.23	$316.23
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $295.12 / $537.03	Professional		$263.03	$295.12	$537.03
United Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $128.82 / $269.15	Facility		$95.50	$128.82	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $120.23 / $177.83	Professional		$85.11	$120.23	$177.83