Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Facility		$165.96	$165.96	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $173.78 / $177.83	Professional		$165.96	$173.78	$177.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $0.02 / $147.91 / $199.53	Professional		$0.02	$147.91	$199.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Facility		$177.83	$177.83	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Professional		$177.83	$177.83	$177.83
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $199.53	Facility		$177.83	$177.83	$199.53
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $208.93	Professional		$177.83	$177.83	$208.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $50.12 / $60.26	Professional		$39.81	$50.12	$60.26
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 / $204.17 / $204.17	Professional		$125.89	$204.17	$204.17