Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $264.83 / $264.83 / $264.83	Facility		$264.83	$264.83	$264.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $264.83 / $275.70 / $275.70	Professional		$264.83	$275.70	$275.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $261.20 / $261.20 / $420.55	Professional		$261.20	$261.20	$420.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $438.75 / $742.50 / $1,181.25	Facility		$438.75	$742.50	$1,181.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $438.75 / $573.75 / $708.75	Professional		$438.75	$573.75	$708.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.00 / $226.63 / $226.63	Facility		$64.00	$226.63	$226.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $192.64 / $192.64 / $192.64	Professional		$192.64	$192.64	$192.64
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $226.63 / $226.63 / $226.63	Facility		$226.63	$226.63	$226.63
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $192.64 / $226.63 / $226.63	Professional		$192.64	$226.63	$226.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $375.00 / $650.00 / $1,179.34	Professional		$375.00	$650.00	$1,179.34