Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $186.21	Facility		$120.23	$120.23	$186.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $125.89 / $204.17	Professional		$97.72	$125.89	$204.17
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $263.03 / $537.03	Facility		$251.19	$263.03	$537.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $147.91 / $316.23	Professional		$123.03	$147.91	$316.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $213.80 / $338.84	Facility		$141.25	$213.80	$338.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $257.04 / $380.19	Professional		$186.21	$257.04	$380.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $169.82	Professional		$123.03	$123.03	$169.82
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $147.91	Professional		$123.03	$123.03	$147.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $151.36 / $213.80	Professional		$107.15	$151.36	$213.80
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Facility		$302.00	$302.00	$302.00
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $281.84 / $512.86	Professional		$251.19	$281.84	$512.86
United Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $169.82 / $257.04	Facility		$100.00	$169.82	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $123.03 / $173.78	Professional		$81.28	$123.03	$173.78