Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $110.55 / $179.80 / $447.99	Facility		$110.55	$179.80	$447.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.83 / $149.83 / $254.71	Professional		$149.83	$149.83	$254.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $220.53 / $344.03 / $955.63	Facility		$220.53	$344.03	$955.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $149.96 / $149.96 / $259.67	Professional		$149.96	$149.96	$259.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.50 / $23.63 / $93.84	Facility		$13.50	$23.63	$93.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.18 / $56.87 / $76.77	Professional		$14.18	$56.87	$76.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $164.66 / $164.66 / $164.66	Facility		$164.66	$164.66	$164.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.66 / $164.66 / $244.49	Professional		$164.66	$164.66	$244.49
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $51.61 / $52.34 / $401.08	Facility		$51.61	$52.34	$401.08
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $164.66 / $164.66 / $244.49	Professional		$164.66	$164.66	$244.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $50.00 / $60.00	Professional		$40.00	$50.00	$60.00
United Facility/Professional Professional Modifier Low / Median / High Price $139.66 / $173.48 / $195.10	Professional		$139.66	$173.48	$195.10