Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $104.71	Facility		$89.13	$89.13	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $107.15	Professional		$89.13	$89.13	$107.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $109.65 / $190.55	Professional		$89.13	$109.65	$190.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $120.23	Professional		$89.13	$89.13	$120.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $89.13	Facility		$85.11	$85.11	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $125.89	Professional		$89.13	$89.13	$125.89
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $89.13	Facility		$85.11	$85.11	$89.13
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $154.88	Professional		$89.13	$89.13	$154.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $102.33 / $134.90	Professional		$87.10	$102.33	$134.90
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 $97.72 / $134.90 / $269.15	Professional		$97.72	$134.90	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $125.89 / $1,659.59	Professional		$72.44	$125.89	$1,659.59