Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $241.53 / $2,485.00 / $10,268.00	Facility		$241.53	$2,485.00	$10,268.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.72 / $135.43 / $241.53	Professional		$128.72	$135.43	$241.53
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $918.00 / $2,118.00 / $8,800.00	Facility		$918.00	$2,118.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.62 / $251.70 / $442.04	Professional		$163.62	$251.70	$442.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $126.27 / $151.52 / $187.54	Facility		$126.27	$151.52	$187.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $138.90 / $138.90 / $188.80	Professional		$138.90	$138.90	$188.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.61 / $577.00 / $1,758.30	Facility		$151.61	$577.00	$1,758.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.82 / $208.35 / $370.00	Professional		$135.82	$208.35	$370.00
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $366.00 / $577.00 / $1,309.85	Facility		$366.00	$577.00	$1,309.85
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $137.90 / $208.35 / $370.15	Professional		$137.90	$208.35	$370.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.01 / $116.40 / $156.91	Professional		$87.01	$116.40	$156.91
United Facility/Professional Facility Modifier Low / Median / High Price $675.00 / $2,499.00 / $5,235.00	Facility		$675.00	$2,499.00	$5,235.00
United Facility/Professional Professional Modifier Low / Median / High Price $121.87 / $185.53 / $323.58	Professional		$121.87	$185.53	$323.58