Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $331.13 / $1,071.52	Facility		$37.15	$331.13	$1,071.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $288.40 / $489.78	Professional		$194.98	$288.40	$489.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $416.87 / $645.65	Professional		$239.88	$416.87	$645.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $602.56 / $1,202.26	Facility		$562.34	$602.56	$1,202.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $316.23 / $724.44	Professional		$269.15	$316.23	$724.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $346.74 / $562.34	Facility		$234.42	$346.74	$562.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $416.87 / $630.96	Professional		$302.00	$416.87	$630.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Facility		$295.12	$295.12	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $295.12	Professional		$213.80	$213.80	$295.12
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $16.60 / $295.12 / $630.96	Facility		$16.60	$295.12	$630.96
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $295.12	Professional		$213.80	$213.80	$295.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $338.84 / $489.78	Professional		$239.88	$338.84	$489.78
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $676.08 / $676.08	Facility		$676.08	$676.08	$676.08
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $645.65 / $1,174.90	Professional		$562.34	$645.65	$1,174.90
United Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $239.88 / $501.19	Facility		$181.97	$239.88	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $251.19 / $354.81	Professional		$162.18	$251.19	$354.81