Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $645.65	Facility		$389.05	$389.05	$645.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $389.05 / $602.56	Professional		$295.12	$389.05	$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 $389.05 / $457.09 / $1,047.13	Professional		$389.05	$457.09	$1,047.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $562.34 / $891.25	Facility		$371.54	$562.34	$891.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $676.08 / $1,023.29	Professional		$489.78	$676.08	$1,023.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Facility		$416.87	$416.87	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $416.87	Professional		$309.03	$309.03	$416.87
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Facility		$416.87	$416.87	$416.87
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $416.87	Professional		$309.03	$309.03	$416.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $660.69 / $954.99	Professional		$416.87	$660.69	$954.99
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $977.24 / $977.24	Facility		$977.24	$977.24	$977.24
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $912.01 / $1,698.24	Professional		$831.76	$912.01	$1,698.24
United Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $501.19 / $776.25	Facility		$302.00	$501.19	$776.25
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $398.11 / $512.86	Professional		$269.15	$398.11	$512.86