Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.91 / $49.91 / $49.91	Facility		$49.91	$49.91	$49.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.91 / $49.91 / $49.91	Professional		$49.91	$49.91	$49.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.34 / $74.90 / $864.43	Professional		$71.34	$74.90	$864.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,833.98 / $2,821.50 / $61,249.39	Facility		$1,833.98	$2,821.50	$61,249.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,833.98 / $2,398.28 / $2,962.58	Professional		$1,833.98	$2,398.28	$2,962.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.00 / $1,300.00 / $1,300.00	Facility		$64.00	$1,300.00	$1,300.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,105.00 / $1,105.00 / $1,300.00	Professional		$1,105.00	$1,105.00	$1,300.00
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,300.00 / $1,300.00 / $1,300.00	Facility		$1,300.00	$1,300.00	$1,300.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,300.00 / $1,300.00 / $1,300.00	Professional		$1,300.00	$1,300.00	$1,300.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,567.50 / $2,717.00 / $4,929.68	Professional		$1,567.50	$2,717.00	$4,929.68