Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $416.87	Facility		$181.97	$181.97	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $194.98 / $346.74	Professional		$162.18	$194.98	$346.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $398.11 / $812.83	Facility		$380.19	$398.11	$812.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $223.87 / $489.78	Professional		$186.21	$223.87	$489.78
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Professional		$316.23	$316.23	$316.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $309.03 / $489.78	Facility		$204.17	$309.03	$489.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $371.54 / $562.34	Professional		$269.15	$371.54	$562.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Facility		$239.88	$239.88	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $239.88	Professional		$173.78	$173.78	$239.88
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Facility		$239.88	$239.88	$239.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $239.88	Professional		$173.78	$173.78	$239.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $223.87 / $323.59	Professional		$162.18	$223.87	$323.59
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $426.58 / $776.25	Professional		$380.19	$426.58	$776.25
United Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $275.42 / $426.58	Facility		$154.88	$275.42	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $186.21 / $281.84	Professional		$123.03	$186.21	$281.84