Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.39 / $81.39 / $240.00	Facility		$81.39	$81.39	$240.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.39 / $86.69 / $147.29	Professional		$81.39	$86.69	$147.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.69 / $162.63 / $261.39	Facility		$138.69	$162.63	$261.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.17 / $117.74 / $288.98	Professional		$113.17	$117.74	$288.98
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $195.89 / $195.89 / $195.89	Professional		$195.89	$195.89	$195.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.95 / $102.89 / $160.04	Facility		$12.95	$102.89	$160.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.67 / $97.17 / $160.04	Professional		$10.67	$97.17	$160.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.50 / $123.50 / $140.96	Facility		$123.50	$123.50	$140.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.98 / $123.50 / $179.25	Professional		$104.98	$123.50	$179.25
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $117.86 / $123.50 / $140.96	Facility		$117.86	$123.50	$140.96
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $104.98 / $123.50 / $123.50	Professional		$104.98	$123.50	$123.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.59 / $97.00 / $139.88	Professional		$77.59	$97.00	$139.88
United Facility/Professional Professional Modifier Low / Median / High Price $56.16 / $94.50 / $150.97	Professional		$56.16	$94.50	$150.97