Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $239.88 / $354.81	Facility		$112.20	$239.88	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $117.49 / $144.54	Professional		$112.20	$117.49	$144.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $177.83 / $776.25	Facility		$128.82	$177.83	$776.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $72.44 / $144.54	Professional		$57.54	$72.44	$144.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Facility		$120.23	$120.23	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $204.17	Professional		$120.23	$120.23	$204.17
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Facility		$120.23	$120.23	$120.23
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $204.17	Professional		$120.23	$120.23	$204.17
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $208.93 / $302.00	Professional		$138.04	$208.93	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Professional		$107.15	$107.15	$107.15