Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.64 / $144.61 / $203.92	Facility		$66.64	$144.61	$203.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $71.66 / $153.27	Professional		$66.64	$71.66	$153.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $71.97 / $116.39 / $191.26	Facility		$71.97	$116.39	$191.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $66.64 / $115.39	Professional		$66.64	$66.64	$115.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $66.64 / $66.64 / $113.29	Facility		$66.64	$66.64	$113.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $66.64 / $89.96	Professional		$66.64	$66.64	$89.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.87 / $62.87 / $66.64	Facility		$62.87	$62.87	$66.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $66.64 / $142.81	Professional		$66.64	$66.64	$142.81
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $66.64 / $142.81	Professional		$66.64	$66.64	$142.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $73.30 / $89.57 / $100.32	Professional		$73.30	$89.57	$100.32
United Facility/Professional Facility Modifier Low / Median / High Price $66.64 / $66.64 / $66.64	Facility		$66.64	$66.64	$66.64
United Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $74.64 / $93.63	Professional		$66.64	$74.64	$93.63