Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.20 / $107.20 / $107.20	Facility		$107.20	$107.20	$107.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.20 / $110.36 / $202.32	Professional		$107.20	$110.36	$202.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $181.03 / $249.49 / $399.18	Facility		$181.03	$249.49	$399.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.31 / $153.44 / $281.07	Professional		$108.31	$153.44	$281.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.55 / $124.24 / $201.98	Facility		$16.55	$124.24	$201.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.98 / $125.22 / $202.28	Professional		$14.98	$125.22	$202.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.15 / $83.15 / $238.46	Facility		$83.15	$83.15	$238.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.70 / $70.68 / $228.75	Professional		$60.70	$70.68	$228.75
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $83.15 / $83.15 / $83.15	Facility		$83.15	$83.15	$83.15
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $70.68 / $83.14 / $83.15	Professional		$70.68	$83.14	$83.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $114.16 / $142.69 / $205.78	Professional		$114.16	$142.69	$205.78
United Facility/Professional Professional Modifier Low / Median / High Price $66.38 / $98.69 / $153.44	Professional		$66.38	$98.69	$153.44