Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $416.87 / $660.69	Facility		$257.04	$416.87	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $223.87 / $316.23	Professional		$162.18	$223.87	$316.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $128.82 / $338.84	Professional		$109.65	$128.82	$338.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $3,801.89 / $41,686.94	Facility		$257.04	$3,801.89	$41,686.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $4,265.80 / $7,585.78	Professional		$338.84	$4,265.80	$7,585.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $575.44	Facility		$177.83	$177.83	$575.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $346.74	Professional		$316.23	$316.23	$346.74
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $281.84 / $1,000.00	Facility		$177.83	$281.84	$1,000.00
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $331.13 / $331.13	Facility		$331.13	$331.13	$331.13
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $288.40 / $549.54	Professional		$204.17	$288.40	$549.54
United Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $245.47 / $275.42	Facility		$100.00	$245.47	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $147.91 / $316.23	Professional		$104.71	$147.91	$316.23