Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.28 / $189.40 / $270.38	Facility		$87.28	$189.40	$270.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $88.16 / $218.20	Professional		$87.28	$88.16	$218.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $94.26 / $140.52 / $248.75	Facility		$94.26	$140.52	$248.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $87.28 / $151.13	Professional		$87.28	$87.28	$151.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $87.28 / $87.28 / $148.38	Facility		$87.28	$87.28	$148.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $87.28 / $117.83	Professional		$87.28	$87.28	$117.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $82.34 / $82.34 / $87.28	Facility		$82.34	$82.34	$87.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $87.28 / $136.87	Professional		$87.28	$87.28	$136.87
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $87.28 / $136.87	Professional		$87.28	$87.28	$136.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $50.00 / $50.00	Professional		$40.00	$50.00	$50.00
United Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $87.28 / $95.35	Professional		$87.28	$87.28	$95.35