Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.30 / $161.51 / $272.83	Facility		$87.30	$161.51	$272.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.30 / $87.30 / $157.53	Professional		$87.30	$87.30	$157.53
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $96.36 / $117.86 / $193.13	Facility		$96.36	$117.86	$193.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.89 / $67.36 / $157.13	Professional		$53.89	$67.36	$157.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $109.13 / $141.87 / $180.06	Facility		$109.13	$141.87	$180.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $141.87 / $147.33 / $261.91	Professional		$141.87	$147.33	$261.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.28 / $124.13 / $622.77	Facility		$112.28	$124.13	$622.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.48 / $83.91 / $263.54	Professional		$55.48	$83.91	$263.54
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $112.28 / $137.60 / $622.77	Facility		$112.28	$137.60	$622.77
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $55.48 / $68.77 / $263.54	Professional		$55.48	$68.77	$263.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.94 / $98.22 / $135.05	Professional		$85.94	$98.22	$135.05
United Facility/Professional Professional Modifier Low / Median / High Price $45.83 / $65.48 / $148.88	Professional		$45.83	$65.48	$148.88