Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $338.84 / $676.08	Facility		$338.84	$338.84	$676.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $338.84 / $549.54	Professional		$263.03	$338.84	$549.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $758.58 / $1,513.56	Facility		$707.95	$758.58	$1,513.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $407.38 / $891.25	Professional		$346.74	$407.38	$891.25
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $588.84 / $588.84	Professional		$588.84	$588.84	$588.84
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 $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $457.09	Professional		$331.13	$331.13	$457.09
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $407.38	Professional		$331.13	$331.13	$407.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $426.58 / $616.60	Professional		$302.00	$426.58	$616.60
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $851.14 / $851.14	Facility		$851.14	$851.14	$851.14
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $794.33 / $1,479.11	Professional		$707.95	$794.33	$1,479.11
United Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $457.09 / $707.95	Facility		$275.42	$457.09	$707.95
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $346.74 / $467.74	Professional		$234.42	$346.74	$467.74