Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.78 / $201.45 / $299.45	Facility		$77.78	$201.45	$299.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.78 / $77.78 / $140.35	Professional		$77.78	$77.78	$140.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.85 / $105.00 / $172.05	Facility		$85.85	$105.00	$172.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.89 / $50.55 / $145.63	Professional		$38.89	$50.55	$145.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $97.22 / $126.39 / $160.41	Facility		$97.22	$126.39	$160.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $126.39 / $131.25 / $233.33	Professional		$126.39	$131.25	$233.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.03 / $110.58 / $554.80	Facility		$100.03	$110.58	$554.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.41 / $62.73 / $211.78	Professional		$44.41	$62.73	$211.78
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $100.03 / $110.58 / $554.80	Facility		$100.03	$110.58	$554.80
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $44.41 / $62.73 / $211.78	Professional		$44.41	$62.73	$211.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.56 / $87.50 / $120.31	Professional		$76.56	$87.50	$120.31
United Facility/Professional Professional Modifier Low / Median / High Price $40.83 / $58.33 / $127.36	Professional		$40.83	$58.33	$127.36