Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $724.44 / $1,348.96	Facility		$17.78	$724.44	$1,348.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $398.11 / $645.65	Professional		$316.23	$398.11	$645.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $562.34 / $1,096.48	Professional		$426.58	$562.34	$1,096.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $575.44 / $912.01	Facility		$380.19	$575.44	$912.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $691.83 / $1,047.13	Professional		$501.19	$691.83	$1,047.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Facility		$501.19	$501.19	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $501.19	Professional		$426.58	$426.58	$501.19
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $5.89 / $501.19 / $501.19	Facility		$5.89	$501.19	$501.19
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $467.74	Professional		$426.58	$426.58	$467.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $707.95 / $1,023.29	Professional		$446.68	$707.95	$1,023.29
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $933.25 / $1,737.80	Professional		$831.76	$933.25	$1,737.80
United Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $467.74 / $537.03	Facility		$295.12	$467.74	$537.03
United Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $407.38 / $537.03	Professional		$275.42	$407.38	$537.03