Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.73 / $66.73 / $66.73	Facility		$66.73	$66.73	$66.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.27 / $66.73 / $102.94	Professional		$65.27	$66.73	$102.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.69 / $155.30 / $248.48	Facility		$112.69	$155.30	$248.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.35 / $69.95 / $161.51	Professional		$53.35	$69.95	$161.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.73 / $89.93 / $136.66	Facility		$11.73	$89.93	$136.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.73 / $89.93 / $130.44	Professional		$11.73	$89.93	$130.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $62.10 / $164.18	Facility		$62.10	$62.10	$164.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.79 / $62.10 / $166.88	Professional		$52.79	$62.10	$166.88
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $62.10 / $62.10	Facility		$62.10	$62.10	$62.10
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $62.10 / $82.64	Professional		$62.10	$62.10	$82.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $71.05 / $88.82 / $128.08	Professional		$71.05	$88.82	$128.08
United Facility/Professional Professional Modifier Low / Median / High Price $41.32 / $61.43 / $88.92	Professional		$41.32	$61.43	$88.92