Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $416.87 / $724.44	Facility		$416.87	$416.87	$724.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $457.09 / $724.44	Professional		$346.74	$457.09	$724.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $933.25 / $1,862.09	Facility		$870.96	$933.25	$1,862.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $512.86 / $1,122.02	Professional		$436.52	$512.86	$1,122.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $776.25 / $1,230.27	Facility		$512.86	$776.25	$1,230.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $933.25 / $1,380.38	Professional		$660.69	$933.25	$1,380.38
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 / $501.19	Professional		$363.08	$363.08	$501.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $524.81 / $758.58	Professional		$371.54	$524.81	$758.58
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility		$1,047.13	$1,047.13	$1,047.13
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $977.24 / $1,819.70	Professional		$870.96	$977.24	$1,819.70
United Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $575.44 / $891.25	Facility		$323.59	$575.44	$891.25
United Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $426.58 / $588.84	Professional		$288.40	$426.58	$588.84