Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $426.58 / $724.44	Facility		$426.58	$426.58	$724.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $436.52 / $724.44	Professional		$371.54	$436.52	$724.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $954.99 / $1,905.46	Facility		$891.25	$954.99	$1,905.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $512.86 / $1,148.15	Professional		$436.52	$512.86	$1,148.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $660.69 / $1,047.13	Facility		$436.52	$660.69	$1,047.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $794.33 / $1,202.26	Professional		$575.44	$794.33	$1,202.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $630.96 / $630.96	Facility		$630.96	$630.96	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $630.96	Professional		$457.09	$457.09	$630.96
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $630.96 / $630.96	Facility		$630.96	$630.96	$630.96
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $630.96	Professional		$457.09	$457.09	$630.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $758.58 / $1,096.48	Professional		$478.63	$758.58	$1,096.48
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $25.70 / $1,071.52	Facility		$25.70	$25.70	$1,071.52
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,000.00 / $1,862.09	Professional		$891.25	$1,000.00	$1,862.09
United Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $588.84 / $912.01	Facility		$323.59	$588.84	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $436.52 / $602.56	Professional		$295.12	$436.52	$602.56