Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $549.54 / $645.65	Facility		$549.54	$549.54	$645.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $691.83	Professional		$549.54	$549.54	$691.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $602.56 / $1,047.13	Professional		$199.53	$602.56	$1,047.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Facility		$549.54	$549.54	$549.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $741.31	Professional		$549.54	$549.54	$741.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $524.81 / $549.54	Facility		$524.81	$524.81	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $794.33	Professional		$549.54	$549.54	$794.33
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $524.81 / $549.54	Facility		$524.81	$524.81	$549.54
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $977.24	Professional		$549.54	$549.54	$977.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $131.83 / $912.01	Professional		$87.10	$131.83	$912.01
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 / $2,691.53 / $2,818.38	Professional		$125.89	$2,691.53	$2,818.38