Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $371.54 / $489.78	Facility		$371.54	$371.54	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $363.08 / $478.63	Professional		$245.47	$363.08	$478.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $812.83 / $1,659.59	Facility		$776.25	$812.83	$1,659.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $436.52 / $1,000.00	Professional		$346.74	$436.52	$1,000.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $426.58 / $691.83	Facility		$288.40	$426.58	$691.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $512.86 / $776.25	Professional		$371.54	$512.86	$776.25
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 / $489.78	Facility		$489.78	$489.78	$489.78
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $457.09	Professional		$363.08	$363.08	$457.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $467.74 / $660.69	Professional		$331.13	$467.74	$660.69
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $933.25	Facility		$933.25	$933.25	$933.25
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $870.96 / $1,621.81	Professional		$776.25	$870.96	$1,621.81
United Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $426.58 / $660.69	Facility		$257.04	$426.58	$660.69
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $371.54 / $489.78	Professional		$223.87	$371.54	$489.78