Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.46 / $105.46 / $2,200.00	Facility		$105.46	$105.46	$2,200.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.46 / $105.46 / $112.05	Professional		$105.46	$105.46	$112.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.50 / $28.50 / $91.89	Professional		$28.50	$28.50	$91.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $58.20 / $59,702.01 / $59,702.01	Facility		$58.20	$59,702.01	$59,702.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47.61 / $112.05 / $112.05	Professional		$47.61	$112.05	$112.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.05 / $112.05 / $112.05	Facility		$112.05	$112.05	$112.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.05 / $112.05 / $112.05	Professional		$112.05	$112.05	$112.05
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $112.05 / $112.05 / $1,307.33	Facility		$112.05	$112.05	$1,307.33
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $112.05 / $112.05 / $131.82	Professional		$112.05	$112.05	$131.82