Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $252.51 / $420.43 / $1,170.00	Facility		$252.51	$420.43	$1,170.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $179.67 / $252.51 / $268.48	Professional		$179.67	$252.51	$268.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $441.44 / $517.13 / $1,339.84	Facility		$441.44	$517.13	$1,339.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.46 / $229.34 / $611.15	Professional		$218.46	$229.34	$611.15
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $399.60 / $399.60 / $399.60	Professional		$399.60	$399.60	$399.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $317.10 / $470.12 / $634.66	Facility		$317.10	$470.12	$634.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $305.58 / $423.11 / $1,006.62	Professional		$305.58	$423.11	$1,006.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $291.02 / $291.02 / $550.39	Facility		$291.02	$291.02	$550.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $212.45 / $212.45 / $314.12	Professional		$212.45	$212.45	$314.12
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $291.02 / $291.02 / $291.02	Facility		$291.02	$291.02	$291.02
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $212.45 / $291.02 / $291.02	Professional		$212.45	$291.02	$291.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $199.42 / $274.20 / $359.48	Professional		$199.42	$274.20	$359.48
United Facility/Professional Facility Modifier Low / Median / High Price $118.54 / $184.46 / $376.10	Facility		$118.54	$184.46	$376.10
United Facility/Professional Professional Modifier Low / Median / High Price $140.18 / $218.59 / $298.42	Professional		$140.18	$218.59	$298.42