Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $371.54	Facility		$218.78	$218.78	$371.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $223.87 / $363.08	Professional		$190.55	$223.87	$363.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $478.63 / $977.24	Facility		$457.09	$478.63	$977.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $269.15 / $588.84	Professional		$223.87	$269.15	$588.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $338.84 / $537.03	Facility		$223.87	$338.84	$537.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $407.38 / $602.56	Professional		$295.12	$407.38	$602.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Facility		$316.23	$316.23	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $316.23	Professional		$234.42	$234.42	$316.23
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Facility		$316.23	$316.23	$316.23
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $316.23	Professional		$234.42	$234.42	$316.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $380.19 / $562.34	Professional		$245.47	$380.19	$562.34
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $25.70 / $549.54	Facility		$25.70	$25.70	$549.54
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $512.86 / $933.25	Professional		$457.09	$512.86	$933.25
United Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $302.00 / $457.09	Facility		$165.96	$302.00	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $218.78 / $309.03	Professional		$147.91	$218.78	$309.03