Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $155.25 / $249.75	Facility		$60.00	$155.25	$249.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $166.80	Professional		$60.00	$60.00	$166.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.64 / $121.31 / $250.97	Facility		$67.64	$121.31	$250.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.64 / $77.78 / $124.71	Professional		$67.64	$77.78	$124.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,414.45 / $1,414.45 / $2,333.84	Facility		$1,414.45	$1,414.45	$2,333.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,414.45 / $1,414.45 / $1,414.45	Professional		$1,414.45	$1,414.45	$1,414.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.75 / $63.75 / $63.75	Facility		$63.75	$63.75	$63.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.75 / $63.75 / $92.28	Professional		$63.75	$63.75	$92.28
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $63.75 / $63.75 / $63.75	Facility		$63.75	$63.75	$63.75
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $63.75 / $63.75 / $92.28	Professional		$63.75	$63.75	$92.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $180.64 / $205.27 / $238.11	Professional		$180.64	$205.27	$238.11
United Facility/Professional Professional Modifier Low / Median / High Price $62.50 / $62.50 / $81.88	Professional		$62.50	$62.50	$81.88