Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $389.05	Facility		$239.88	$239.88	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $245.47 / $389.05	Professional		$190.55	$245.47	$389.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $524.81 / $1,071.52	Facility		$501.19	$524.81	$1,071.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $288.40 / $630.96	Professional		$245.47	$288.40	$630.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $338.84 / $537.03	Facility		$223.87	$338.84	$537.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $407.38 / $602.56	Professional		$295.12	$407.38	$602.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Facility		$316.23	$316.23	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $316.23	Professional		$229.09	$229.09	$316.23
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Facility		$316.23	$316.23	$316.23
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $316.23	Professional		$229.09	$229.09	$316.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $295.12 / $426.58	Professional		$213.80	$295.12	$426.58
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $602.56 / $602.56	Facility		$602.56	$602.56	$602.56
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $562.34 / $1,023.29	Professional		$501.19	$562.34	$1,023.29
United Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $331.13 / $512.86	Facility		$199.53	$331.13	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $245.47 / $338.84	Professional		$162.18	$245.47	$338.84