Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $380.19 / $512.86	Facility		$380.19	$380.19	$512.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $363.08 / $512.86	Professional		$257.04	$363.08	$512.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $831.76 / $1,698.24	Facility		$794.33	$831.76	$1,698.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $457.09 / $1,000.00	Professional		$354.81	$457.09	$1,000.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $457.09 / $741.31	Facility		$309.03	$457.09	$741.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $549.54 / $831.76	Professional		$398.11	$549.54	$831.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Facility		$501.19	$501.19	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $501.19	Professional		$363.08	$363.08	$501.19
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Facility		$501.19	$501.19	$501.19
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $436.52	Professional		$363.08	$363.08	$436.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $467.74 / $676.08	Professional		$338.84	$467.74	$676.08
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $954.99 / $954.99	Facility		$954.99	$954.99	$954.99
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $891.25 / $1,621.81	Professional		$794.33	$891.25	$1,621.81
United Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $436.52 / $676.08	Facility		$239.88	$436.52	$676.08
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $371.54 / $478.63	Professional		$239.88	$371.54	$478.63