Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $190.55	Facility		$162.18	$162.18	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $204.17	Professional		$162.18	$162.18	$204.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $177.83 / $302.00	Professional		$151.36	$177.83	$302.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $218.78	Professional		$162.18	$162.18	$218.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $162.18	Facility		$151.36	$151.36	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $229.09	Professional		$162.18	$162.18	$229.09
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $162.18	Facility		$151.36	$151.36	$162.18
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $275.42	Professional		$162.18	$162.18	$275.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $50.12 / $177.83	Professional		$39.81	$50.12	$177.83
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $144.54 / $158.49	Facility		$134.90	$144.54	$158.49
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $144.54 / $269.15	Professional		$123.03	$144.54	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $169.82 / $371.54	Professional		$125.89	$169.82	$371.54