Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $181.97	Facility		$104.71	$104.71	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $107.15 / $177.83	Professional		$91.20	$107.15	$177.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $234.42 / $467.74	Facility		$218.78	$234.42	$467.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $87.10 / $263.03	Professional		$58.88	$87.10	$263.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $162.18 / $263.03	Facility		$109.65	$162.18	$263.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $194.98 / $295.12	Professional		$141.25	$194.98	$295.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $169.82	Professional		$144.54	$144.54	$169.82
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $169.82	Professional		$144.54	$144.54	$169.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $158.49 / $223.87	Professional		$112.20	$158.49	$223.87
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $263.03 / $263.03	Facility		$263.03	$263.03	$263.03
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $245.47 / $457.09	Professional		$218.78	$245.47	$457.09
United Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $144.54 / $223.87	Facility		$79.43	$144.54	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $107.15 / $151.36	Professional		$72.44	$107.15	$151.36