Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $331.13	Facility		$199.53	$199.53	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $199.53 / $316.23	Professional		$158.49	$199.53	$316.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $436.52 / $891.25	Facility		$416.87	$436.52	$891.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $239.88 / $524.81	Professional		$199.53	$239.88	$524.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $275.42 / $436.52	Facility		$181.97	$275.42	$436.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $331.13 / $489.78	Professional		$239.88	$331.13	$489.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Facility		$275.42	$275.42	$275.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $275.42	Professional		$199.53	$199.53	$275.42
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Facility		$275.42	$275.42	$275.42
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $245.47	Professional		$199.53	$199.53	$245.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $245.47 / $354.81	Professional		$177.83	$245.47	$354.81
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Facility		$501.19	$501.19	$501.19
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $467.74 / $851.14	Professional		$416.87	$467.74	$851.14
United Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $275.42 / $426.58	Facility		$165.96	$275.42	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $199.53 / $281.84	Professional		$134.90	$199.53	$281.84