Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $195.24 / $798.00 / $1,300.00	Facility		$195.24	$798.00	$1,300.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.53 / $195.24 / $245.75	Professional		$183.53	$195.24	$245.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $276.00 / $1,045.00 / $2,137.00	Facility		$276.00	$1,045.00	$2,137.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.79 / $196.95 / $363.33	Professional		$134.79	$196.95	$363.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $198.75 / $2,096.34 / $5,132.33	Facility		$198.75	$2,096.34	$5,132.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $207.33 / $2,534.04 / $4,664.93	Professional		$207.33	$2,534.04	$4,664.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $223.70 / $223.70 / $400.00	Facility		$223.70	$223.70	$400.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.00 / $275.00 / $935.47	Professional		$240.00	$275.00	$935.47
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $223.70 / $349.71 / $400.00	Facility		$223.70	$349.71	$400.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $240.00 / $275.00 / $935.47	Professional		$240.00	$275.00	$935.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $50.00 / $60.00	Professional		$40.00	$50.00	$60.00
United Facility/Professional Facility Modifier Low / Median / High Price $131.59 / $135.44 / $190.58	Facility		$131.59	$135.44	$190.58
United Facility/Professional Professional Modifier Low / Median / High Price $149.91 / $194.90 / $346.52	Professional		$149.91	$194.90	$346.52