Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $263.03	Facility		$199.53	$199.53	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $194.98 / $257.04	Professional		$138.04	$194.98	$257.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $446.68 / $891.25	Facility		$416.87	$446.68	$891.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $234.42 / $537.03	Professional		$186.21	$234.42	$537.03
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $346.74 / $346.74	Professional		$346.74	$346.74	$346.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $229.09 / $371.54	Facility		$154.88	$229.09	$371.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $275.42 / $416.87	Professional		$199.53	$275.42	$416.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $263.03 / $263.03	Facility		$263.03	$263.03	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $263.03	Professional		$194.98	$194.98	$263.03
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $263.03 / $263.03	Facility		$263.03	$263.03	$263.03
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $208.93	Professional		$194.98	$194.98	$208.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $251.19 / $363.08	Professional		$177.83	$251.19	$363.08
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Facility		$501.19	$501.19	$501.19
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $467.74 / $870.96	Professional		$416.87	$467.74	$870.96
United Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $229.09 / $354.81	Facility		$138.04	$229.09	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $199.53 / $257.04	Professional		$125.89	$199.53	$257.04