Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $281.84 / $302.00	Facility		$169.82	$281.84	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $169.82 / $269.15	Professional		$138.04	$169.82	$269.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $338.84 / $691.83	Facility		$323.59	$338.84	$691.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $190.55 / $416.87	Professional		$154.88	$190.55	$416.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $257.04 / $407.38	Facility		$169.82	$257.04	$407.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $309.03 / $457.09	Professional		$223.87	$309.03	$457.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $204.17	Professional		$151.36	$151.36	$204.17
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $467.74	Facility		$204.17	$204.17	$467.74
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $204.17	Professional		$151.36	$151.36	$204.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $213.80 / $302.00	Professional		$151.36	$213.80	$302.00
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Facility		$389.05	$389.05	$389.05
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $363.08 / $660.69	Professional		$323.59	$363.08	$660.69
United Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $173.78 / $363.08	Facility		$131.83	$173.78	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $158.49 / $239.88	Professional		$104.71	$158.49	$239.88