Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Facility		$85.11	$85.11	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $107.15 / $141.25	Professional		$79.43	$107.15	$141.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $173.78 / $245.47	Facility		$162.18	$173.78	$245.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $138.04 / $562.34	Professional		$54.95	$138.04	$562.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $120.23 / $158.49	Facility		$15.85	$120.23	$158.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $186.21	Professional		$83.18	$83.18	$186.21
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $97.72	Professional		$83.18	$83.18	$97.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $3,630.78 / $5,754.40	Professional		$1,819.70	$3,630.78	$5,754.40
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $162.18 / $275.42	Professional		$138.04	$162.18	$275.42
United Facility/Professional Facility Modifier Low / Median / High Price $8.71 / $66.07 / $125.89	Facility		$8.71	$66.07	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $93.33 / $131.83	Professional		$60.26	$93.33	$131.83