Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.63 / $283.50 / $689.96	Facility		$99.63	$283.50	$689.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.98 / $101.98 / $155.01	Professional		$101.98	$101.98	$155.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $159.36 / $248.60 / $690.56	Facility		$159.36	$248.60	$690.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.36 / $217.02 / $344.30	Professional		$108.36	$217.02	$344.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $106.67 / $106.67 / $112.00	Facility		$106.67	$106.67	$112.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.67 / $106.67 / $106.67	Professional		$106.67	$106.67	$106.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $108.36 / $108.36 / $108.36	Facility		$108.36	$108.36	$108.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.36 / $108.36 / $127.48	Professional		$108.36	$108.36	$127.48
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $5.09 / $87.39 / $403.04	Facility		$5.09	$87.39	$403.04
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $108.36 / $108.36 / $153.80	Professional		$108.36	$108.36	$153.80
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 $106.24 / $106.24 / $139.16	Professional		$106.24	$106.24	$139.16