Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $1,047.13 / $1,548.82	Facility		$47.86	$1,047.13	$1,548.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $50.12 / $1,621.81	Professional		$30.20	$50.12	$1,621.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,047.13 / $1,288.25	Professional		$794.33	$1,047.13	$1,288.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $204.17 / $575.44	Facility		$125.89	$204.17	$575.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $213.80 / $645.65	Professional		$199.53	$213.80	$645.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Facility		$61.66	$61.66	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $954.99 / $1,380.38	Professional		$630.96	$954.99	$1,380.38
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $933.25 / $1,288.25	Professional		$645.65	$933.25	$1,288.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $141.25 / $263.03	Professional		$52.48	$141.25	$263.03
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $758.58 / $1,584.89	Professional		$323.59	$758.58	$1,584.89
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $54.95 / $75.86	Professional		$39.81	$54.95	$75.86