Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $575.44	Facility		$575.44	$575.44	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $602.56 / $616.60	Professional		$575.44	$602.56	$616.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $741.31 / $1,258.93	Professional		$199.53	$741.31	$1,258.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Facility		$616.60	$616.60	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Professional		$616.60	$616.60	$616.60
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Facility		$616.60	$616.60	$616.60
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $724.44	Professional		$616.60	$616.60	$724.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $87.10 / $131.83	Professional		$30.20	$87.10	$131.83
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 / $724.44 / $724.44	Professional		$125.89	$724.44	$724.44