Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $151.36	Facility		$114.82	$114.82	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $107.15 / $147.91	Professional		$77.62	$107.15	$147.91
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $251.19 / $512.86	Facility		$239.88	$251.19	$512.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $131.83 / $302.00	Professional		$107.15	$131.83	$302.00
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Professional		$199.53	$199.53	$199.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $131.83 / $208.93	Facility		$87.10	$131.83	$208.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $158.49 / $234.42	Professional		$114.82	$158.49	$234.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $112.20	Professional		$83.18	$83.18	$112.20
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $112.20	Professional		$83.18	$83.18	$112.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $141.25 / $204.17	Professional		$102.33	$141.25	$204.17
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $288.40 / $288.40	Facility		$288.40	$288.40	$288.40
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $269.15 / $489.78	Professional		$239.88	$269.15	$489.78
United Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $131.83 / $204.17	Facility		$75.86	$131.83	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $114.82 / $144.54	Professional		$69.18	$114.82	$144.54