Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.45 / $156.22 / $395.72	Facility		$90.45	$156.22	$395.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.29 / $113.58 / $195.28	Professional		$84.29	$113.58	$195.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $814.00 / $1,927.00 / $3,943.00	Facility		$814.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.63 / $90.03 / $147.79	Professional		$64.63	$90.03	$147.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $83.60 / $91.20 / $132.80	Facility		$83.60	$91.20	$132.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $86.03 / $130.44 / $166.01	Professional		$86.03	$130.44	$166.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,571.00 / $21,571.00 / $21,571.00	Facility		$21,571.00	$21,571.00	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.84 / $141.07 / $213.45	Professional		$100.84	$141.07	$213.45
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $159.97 / $159.97 / $159.97	Facility		$159.97	$159.97	$159.97
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $103.05 / $142.30 / $217.02	Professional		$103.05	$142.30	$217.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $106.30 / $150.61	Professional		$81.79	$106.30	$150.61
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $881.00 / $2,833.00	Facility		$444.00	$881.00	$2,833.00
United Facility/Professional Professional Modifier Low / Median / High Price $93.99 / $145.47 / $239.55	Professional		$93.99	$145.47	$239.55