Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $537.03	Facility		$457.09	$457.09	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $512.86	Professional		$457.09	$457.09	$512.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $501.19 / $851.14	Professional		$194.98	$501.19	$851.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $616.60	Professional		$457.09	$457.09	$616.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $436.52 / $457.09	Facility		$436.52	$436.52	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $645.65	Professional		$457.09	$457.09	$645.65
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $436.52 / $457.09	Facility		$436.52	$436.52	$457.09
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $794.33	Professional		$457.09	$457.09	$794.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $102.33 / $512.86	Professional		$87.10	$102.33	$512.86
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 / $331.13	Professional		$123.03	$144.54	$331.13
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $501.19 / $1,659.59	Professional		$125.89	$501.19	$1,659.59