Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.75 / $80.75 / $80.75	Facility		$80.75	$80.75	$80.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.64 / $80.75 / $116.98	Professional		$72.64	$80.75	$116.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $137.16 / $189.03 / $302.44	Facility		$137.16	$189.03	$302.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.49 / $112.50 / $216.44	Professional		$97.49	$112.50	$216.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.63 / $108.18 / $160.28	Facility		$13.63	$108.18	$160.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.11 / $102.17 / $197.96	Professional		$12.11	$102.17	$197.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.52 / $93.52 / $166.03	Facility		$93.52	$93.52	$166.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.48 / $93.52 / $172.50	Professional		$79.48	$93.52	$172.50
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $93.52 / $93.52 / $122.74	Facility		$93.52	$93.52	$122.74
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $93.52 / $93.52 / $122.74	Professional		$93.52	$93.52	$122.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $91.67 / $114.59 / $165.25	Professional		$91.67	$114.59	$165.25
United Facility/Professional Professional Modifier Low / Median / High Price $47.13 / $74.51 / $102.27	Professional		$47.13	$74.51	$102.27