Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $338.84	Facility		$204.17	$204.17	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $213.80 / $331.13	Professional		$186.21	$213.80	$331.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $457.09 / $912.01	Facility		$426.58	$457.09	$912.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $263.03 / $549.54	Professional		$213.80	$263.03	$549.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $323.59 / $524.81	Facility		$218.78	$323.59	$524.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $389.05 / $588.84	Professional		$281.84	$389.05	$588.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Facility		$275.42	$275.42	$275.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $275.42	Professional		$199.53	$199.53	$275.42
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Facility		$275.42	$275.42	$275.42
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $275.42	Professional		$199.53	$199.53	$275.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $346.74 / $512.86	Professional		$223.87	$346.74	$512.86
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $512.86 / $512.86	Facility		$512.86	$512.86	$512.86
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $478.63 / $891.25	Professional		$426.58	$478.63	$891.25
United Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $295.12 / $446.68	Facility		$162.18	$295.12	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $208.93 / $302.00	Professional		$141.25	$208.93	$302.00