Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $194.98 / $275.42	Facility		$107.15	$194.98	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $93.33 / $144.54	Professional		$79.43	$93.33	$144.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $120.23 / $208.93	Facility		$104.71	$120.23	$208.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $125.89 / $199.53	Professional		$45.71	$125.89	$199.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $131.83	Facility		$79.43	$79.43	$131.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $1,778.28 / $3,162.28	Professional		$141.25	$1,778.28	$3,162.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $389.05	Facility		$74.13	$74.13	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $131.83 / $165.96	Professional		$74.13	$131.83	$165.96
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $117.49 / $389.05	Facility		$74.13	$117.49	$389.05
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Professional		$74.13	$74.13	$74.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Professional		$63.10	$63.10	$63.10
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Facility		$138.04	$138.04	$138.04
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $120.23 / $229.09	Professional		$74.13	$120.23	$229.09
United Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $69.18 / $114.82	Facility		$40.74	$69.18	$114.82
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $69.18 / $114.82	Professional		$47.86	$69.18	$114.82