Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $165.96 / $269.15	Facility		$151.36	$165.96	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $125.89 / $186.21	Professional		$87.10	$125.89	$186.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $302.00 / $616.60	Facility		$288.40	$302.00	$616.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $158.49 / $363.08	Professional		$128.82	$158.49	$363.08
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Professional		$239.88	$239.88	$239.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $158.49 / $257.04	Facility		$107.15	$158.49	$257.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $190.55 / $288.40	Professional		$138.04	$190.55	$288.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Facility		$151.36	$151.36	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $151.36	Professional		$109.65	$109.65	$151.36
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $288.40	Facility		$151.36	$151.36	$288.40
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $151.36	Professional		$109.65	$109.65	$151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $173.78 / $245.47	Professional		$123.03	$173.78	$245.47
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $346.74 / $346.74	Facility		$346.74	$346.74	$346.74
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $323.59 / $602.56	Professional		$288.40	$323.59	$602.56
United Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $112.20 / $245.47	Facility		$85.11	$112.20	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $128.82 / $177.83	Professional		$79.43	$128.82	$177.83