Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $338.84 / $489.78	Facility		$338.84	$338.84	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $338.84 / $489.78	Professional		$251.19	$338.84	$489.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $741.31 / $1,513.56	Facility		$707.95	$741.31	$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
CareSource Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $436.52 / $707.95	Facility		$295.12	$436.52	$707.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $524.81 / $794.33	Professional		$380.19	$524.81	$794.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Facility		$478.63	$478.63	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $354.81 / $478.63	Professional		$354.81	$354.81	$478.63
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Facility		$478.63	$478.63	$478.63
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $354.81 / $398.11	Professional		$354.81	$354.81	$398.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $416.87 / $602.56	Professional		$302.00	$416.87	$602.56
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $831.76	Facility		$831.76	$831.76	$831.76
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $776.25 / $1,445.44	Professional		$707.95	$776.25	$1,445.44
United Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $436.52 / $676.08	Facility		$263.03	$436.52	$676.08
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $338.84 / $446.68	Professional		$229.09	$338.84	$446.68