Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.59 / $340.70 / $503.65	Facility		$164.59	$340.70	$503.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $169.81 / $445.69	Professional		$164.59	$169.81	$445.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.76 / $264.99 / $411.48	Facility		$177.76	$264.99	$411.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $164.59 / $285.00	Professional		$164.59	$164.59	$285.00
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $220.55 / $220.55 / $220.55	Facility		$220.55	$220.55	$220.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $164.59 / $164.59 / $279.80	Facility		$164.59	$164.59	$279.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $164.59 / $222.20	Professional		$164.59	$164.59	$222.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $155.27 / $155.27 / $164.59	Facility		$155.27	$155.27	$164.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $164.59 / $303.68	Professional		$164.59	$164.59	$303.68
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $164.59 / $303.68	Professional		$164.59	$164.59	$303.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $181.04 / $210.16 / $238.65	Professional		$181.04	$210.16	$238.65
United Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $164.59 / $214.30	Professional		$164.59	$164.59	$214.30