Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $398.11 / $676.08	Facility		$398.11	$398.11	$676.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $398.11 / $602.56	Professional		$302.00	$398.11	$602.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $870.96 / $1,778.28	Facility		$831.76	$870.96	$1,778.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $467.74 / $1,047.13	Professional		$398.11	$467.74	$1,047.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $524.81 / $851.14	Facility		$354.81	$524.81	$851.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $630.96 / $954.99	Professional		$457.09	$630.96	$954.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $524.81 / $524.81	Facility		$524.81	$524.81	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $524.81	Professional		$389.05	$389.05	$524.81
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $524.81 / $524.81	Facility		$524.81	$524.81	$524.81
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $489.78	Professional		$389.05	$389.05	$489.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $407.38 / $588.84	Professional		$288.40	$407.38	$588.84
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,000.00	Facility		$1,000.00	$1,000.00	$1,000.00
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $933.25 / $1,698.24	Professional		$831.76	$933.25	$1,698.24
United Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $524.81 / $812.83	Facility		$295.12	$524.81	$812.83
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $407.38 / $537.03	Professional		$269.15	$407.38	$537.03