Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $380.19 / $676.08	Facility		$380.19	$380.19	$676.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $380.19 / $616.60	Professional		$295.12	$380.19	$616.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $831.76 / $1,698.24	Facility		$794.33	$831.76	$1,698.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $467.74 / $1,000.00	Professional		$389.05	$467.74	$1,000.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $524.81 / $831.76	Facility		$346.74	$524.81	$831.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $630.96 / $933.25	Professional		$446.68	$630.96	$933.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Facility		$501.19	$501.19	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $501.19	Professional		$363.08	$363.08	$501.19
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Facility		$501.19	$501.19	$501.19
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $467.74	Professional		$363.08	$363.08	$467.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $467.74 / $676.08	Professional		$338.84	$467.74	$676.08
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $954.99 / $954.99	Facility		$954.99	$954.99	$954.99
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $891.25 / $1,621.81	Professional		$794.33	$891.25	$1,621.81
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $524.81 / $794.33	Facility		$316.23	$524.81	$794.33
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $380.19 / $537.03	Professional		$257.04	$380.19	$537.03