Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.50 / $151.65 / $375.25	Facility		$125.50	$151.65	$375.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.50 / $125.50 / $215.99	Professional		$125.50	$125.50	$215.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $0.02 / $0.03 / $0.07	Facility		$0.02	$0.03	$0.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.00 / $135.00 / $222.75	Professional		$135.00	$135.00	$222.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.73 / $75.73 / $124.95	Facility		$75.73	$75.73	$124.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75.73 / $75.73 / $75.73	Professional		$75.73	$75.73	$75.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $137.94 / $137.94 / $137.94	Facility		$137.94	$137.94	$137.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.94 / $137.94 / $217.05	Professional		$137.94	$137.94	$217.05
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $137.94 / $137.94 / $217.05	Professional		$137.94	$137.94	$217.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $139.02 / $176.94 / $267.94	Professional		$139.02	$176.94	$267.94
United Facility/Professional Professional Modifier Low / Median / High Price $140.27 / $147.65 / $181.48	Professional		$140.27	$147.65	$181.48