Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.75 / $97.75 / $97.75	Facility		$97.75	$97.75	$97.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.94 / $97.75 / $170.39	Professional		$92.94	$97.75	$170.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $166.04 / $228.83 / $366.12	Facility		$166.04	$228.83	$366.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $139.44 / $158.19 / $268.37	Professional		$139.44	$158.19	$268.37
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $206.87 / $223.11 / $223.99	Professional		$206.87	$223.11	$223.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $17.55 / $142.80 / $223.99	Facility		$17.55	$142.80	$223.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.56 / $137.30 / $283.50	Professional		$15.56	$137.30	$283.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.47 / $114.47 / $225.56	Facility		$114.47	$114.47	$225.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.30 / $114.47 / $202.50	Professional		$97.30	$114.47	$202.50
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $114.47 / $114.47 / $150.25	Facility		$114.47	$114.47	$150.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $100.12 / $114.47 / $150.25	Professional		$100.12	$114.47	$150.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $180.00 / $250.00	Professional		$120.00	$180.00	$250.00
United Facility/Professional Professional Modifier Low / Median / High Price $63.38 / $101.03 / $158.10	Professional		$63.38	$101.03	$158.10