Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $338.84	Facility		$213.80	$213.80	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $213.80 / $371.54	Professional		$169.82	$213.80	$371.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $467.74 / $954.99	Facility		$446.68	$467.74	$954.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $263.03 / $575.44	Professional		$218.78	$263.03	$575.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $363.08 / $575.44	Facility		$239.88	$363.08	$575.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $436.52 / $645.65	Professional		$316.23	$436.52	$645.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Facility		$302.00	$302.00	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $302.00	Professional		$223.87	$223.87	$302.00
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Facility		$302.00	$302.00	$302.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $263.03	Professional		$223.87	$223.87	$263.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $269.15 / $380.19	Professional		$190.55	$269.15	$380.19
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $537.03 / $537.03	Facility		$537.03	$537.03	$537.03
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $501.19 / $933.25	Professional		$446.68	$501.19	$933.25
United Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $288.40 / $446.68	Facility		$173.78	$288.40	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $218.78 / $295.12	Professional		$144.54	$218.78	$295.12