Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.63 / $142.41 / $218.55	Facility		$65.63	$142.41	$218.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.63 / $66.38 / $164.08	Professional		$65.63	$66.38	$164.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $70.88 / $105.66 / $187.05	Facility		$70.88	$105.66	$187.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.63 / $65.63 / $110.65	Professional		$65.63	$65.63	$110.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $65.63 / $65.63 / $111.57	Facility		$65.63	$65.63	$111.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $65.63 / $65.63 / $88.60	Professional		$65.63	$65.63	$88.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.91 / $61.91 / $65.63	Facility		$61.91	$61.91	$65.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.63 / $65.63 / $99.66	Professional		$65.63	$65.63	$99.66
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $65.63 / $65.63 / $99.66	Professional		$65.63	$65.63	$99.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $72.19 / $82.16 / $95.16	Professional		$72.19	$82.16	$95.16
United Facility/Professional Facility Modifier Low / Median / High Price $77.93 / $77.93 / $77.93	Facility		$77.93	$77.93	$77.93
United Facility/Professional Professional Modifier Low / Median / High Price $65.63 / $65.63 / $70.98	Professional		$65.63	$65.63	$70.98