Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.94 / $223.38 / $342.79	Facility		$102.94	$223.38	$342.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.50 / $103.52 / $260.44	Professional		$102.50	$103.52	$260.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $111.16 / $179.77 / $306.76	Facility		$111.16	$179.77	$306.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $185.24	Professional		$102.94	$102.94	$185.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $102.94 / $102.94 / $175.00	Facility		$102.94	$102.94	$175.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $138.97	Professional		$102.94	$102.94	$138.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.11 / $97.11 / $102.94	Facility		$97.11	$97.11	$102.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $236.71	Professional		$102.94	$102.94	$236.71
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $236.71	Professional		$102.94	$102.94	$236.71
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 Facility Modifier Low / Median / High Price $102.93 / $102.93 / $102.93	Facility		$102.93	$102.93	$102.93
United Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $134.03	Professional		$102.94	$102.94	$134.03