Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $630.96 / $812.83	Facility		$457.09	$630.96	$812.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $457.09 / $676.08	Professional		$389.05	$457.09	$676.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $933.25 / $1,862.09	Facility		$870.96	$933.25	$1,862.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $512.86 / $1,122.02	Professional		$426.58	$512.86	$1,122.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $660.69 / $1,047.13	Facility		$436.52	$660.69	$1,047.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $794.33 / $1,174.90	Professional		$562.34	$794.33	$1,174.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $575.44	Facility		$575.44	$575.44	$575.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $575.44	Professional		$426.58	$426.58	$575.44
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $1,174.90	Facility		$575.44	$575.44	$1,174.90
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $575.44	Professional		$426.58	$426.58	$575.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $588.84 / $851.14	Professional		$426.58	$588.84	$851.14
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility		$1,047.13	$1,047.13	$1,047.13
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $977.24 / $1,819.70	Professional		$870.96	$977.24	$1,819.70
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $436.52 / $933.25	Facility		$316.23	$436.52	$933.25
United Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $416.87 / $794.33	Professional		$288.40	$416.87	$794.33