Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $588.84 / $707.95	Facility		$398.11	$588.84	$707.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $398.11 / $602.56	Professional		$323.59	$398.11	$602.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $812.83 / $1,621.81	Facility		$758.58	$812.83	$1,621.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $467.74 / $977.24	Professional		$363.08	$467.74	$977.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $602.56 / $954.99	Facility		$398.11	$602.56	$954.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $724.44 / $1,071.52	Professional		$512.86	$724.44	$1,071.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Facility		$446.68	$446.68	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $446.68	Professional		$331.13	$331.13	$446.68
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $1,096.48	Facility		$446.68	$446.68	$1,096.48
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $446.68	Professional		$331.13	$331.13	$446.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $457.09 / $660.69	Professional		$323.59	$457.09	$660.69
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $912.01	Facility		$912.01	$912.01	$912.01
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $851.14 / $1,584.89	Professional		$758.58	$851.14	$1,584.89
United Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $398.11 / $831.76	Facility		$302.00	$398.11	$831.76
United Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $363.08 / $537.03	Professional		$251.19	$363.08	$537.03