Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $549.54 / $977.24	Facility		$389.05	$549.54	$977.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $323.59 / $416.87	Professional		$173.78	$323.59	$416.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $56.23 / $512.86	Professional		$42.66	$56.23	$512.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $5,623.41 / $41,686.94	Facility		$380.19	$5,623.41	$41,686.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $6,456.54 / $11,220.18	Professional		$501.19	$6,456.54	$11,220.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $263.03 / $851.14	Facility		$263.03	$263.03	$851.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $467.74 / $524.81	Professional		$144.54	$467.74	$524.81
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $416.87 / $1,412.54	Facility		$275.42	$416.87	$1,412.54
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Professional		$144.54	$144.54	$144.54
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Facility		$489.78	$489.78	$489.78
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $446.68 / $812.83	Professional		$346.74	$446.68	$812.83
United Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $363.08 / $407.38	Facility		$147.91	$363.08	$407.38
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $147.91 / $407.38	Professional		$104.71	$147.91	$407.38