Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $154.88 / $218.78	Facility		$87.10	$154.88	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $75.86 / $109.65	Professional		$64.57	$75.86	$109.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $97.72 / $169.82	Facility		$83.18	$97.72	$169.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $794.33 / $1,412.54	Professional		$97.72	$794.33	$1,412.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $1,288.25 / $41,686.94	Facility		$85.11	$1,288.25	$41,686.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $1,445.44 / $2,511.89	Professional		$112.20	$1,445.44	$2,511.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $346.74	Facility		$60.26	$60.26	$346.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $107.15 / $117.49	Professional		$60.26	$107.15	$117.49
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $93.33 / $380.19	Facility		$61.66	$93.33	$380.19
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Professional		$60.26	$60.26	$60.26
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Facility		$109.65	$109.65	$109.65
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $100.00 / $213.80	Professional		$77.62	$100.00	$213.80
United Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $83.18 / $91.20	Facility		$33.11	$83.18	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $54.95 / $112.20	Professional		$38.90	$54.95	$112.20