Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.40 / $218.20 / $317.24	Facility		$82.40	$218.20	$317.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.40 / $82.40 / $147.50	Professional		$82.40	$82.40	$147.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $90.95 / $113.30 / $182.28	Facility		$90.95	$113.30	$182.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.87 / $50.87 / $111.24	Professional		$50.87	$50.87	$111.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $68.70 / $103.00 / $139.05	Facility		$68.70	$103.00	$139.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $87.55 / $133.90 / $139.05	Professional		$87.55	$133.90	$139.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.95 / $106.05 / $662.73	Facility		$66.95	$106.05	$662.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.34 / $82.67 / $149.93	Professional		$52.34	$82.67	$149.93
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $66.95 / $106.05 / $662.73	Facility		$66.95	$106.05	$662.73
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $52.34 / $65.65 / $137.50	Professional		$52.34	$65.65	$137.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.25 / $84.97 / $123.60	Professional		$77.25	$84.97	$123.60
United Facility/Professional Professional Modifier Low / Median / High Price $43.26 / $61.80 / $143.85	Professional		$43.26	$61.80	$143.85