Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $724.44 / $741.31	Facility		$426.58	$724.44	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $436.52 / $724.44	Professional		$346.74	$436.52	$724.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $851.14 / $1,737.80	Facility		$812.83	$851.14	$1,737.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $478.63 / $1,047.13	Professional		$389.05	$478.63	$1,047.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $707.95 / $1,148.15	Facility		$467.74	$707.95	$1,148.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $851.14 / $1,288.25	Professional		$616.60	$851.14	$1,288.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Facility		$489.78	$489.78	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $489.78	Professional		$363.08	$363.08	$489.78
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $1,288.25	Facility		$489.78	$489.78	$1,288.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $489.78	Professional		$363.08	$363.08	$489.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $870.96 / $1,258.93	Professional		$549.54	$870.96	$1,258.93
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $977.24 / $977.24	Facility		$977.24	$977.24	$977.24
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $912.01 / $1,659.59	Professional		$812.83	$912.01	$1,659.59
United Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $436.52 / $912.01	Facility		$331.13	$436.52	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $398.11 / $588.84	Professional		$263.03	$398.11	$588.84