Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.90 / $103.90 / $103.90	Facility		$103.90	$103.90	$103.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $103.90 / $194.28	Professional		$101.72	$103.90	$194.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $176.47 / $243.20 / $389.12	Facility		$176.47	$243.20	$389.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $148.43 / $190.47 / $398.05	Professional		$148.43	$190.47	$398.05
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $236.96 / $256.52 / $269.83	Professional		$236.96	$256.52	$269.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $19.46 / $161.47 / $269.83	Facility		$19.46	$161.47	$269.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $17.60 / $151.80 / $312.44	Professional		$17.60	$151.80	$312.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.59 / $123.59 / $319.70	Facility		$123.59	$123.59	$319.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.05 / $123.59 / $222.38	Professional		$105.05	$123.59	$222.38
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $123.59 / $123.59 / $170.42	Facility		$123.59	$123.59	$170.42
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $123.59 / $123.59 / $123.59	Professional		$123.59	$123.59	$123.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $134.30 / $201.45 / $279.80	Professional		$134.30	$201.45	$279.80
United Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $117.64 / $188.22	Professional		$70.00	$117.64	$188.22