Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $182.44 / $405.00 / $839.27	Facility		$182.44	$405.00	$839.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.45 / $195.79 / $446.40	Professional		$182.45	$195.79	$446.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $197.05 / $318.64 / $523.63	Facility		$197.05	$318.64	$523.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.45 / $182.45 / $307.61	Professional		$182.45	$182.45	$307.61
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $244.48 / $244.48 / $244.48	Facility		$244.48	$244.48	$244.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $182.45 / $195.79 / $275.50	Facility		$182.45	$195.79	$275.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $182.45 / $195.79 / $246.31	Professional		$182.45	$195.79	$246.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $172.12 / $172.12 / $182.45	Facility		$172.12	$172.12	$182.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $182.45 / $182.45 / $286.39	Professional		$182.45	$182.45	$286.39
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $159.09 / $182.45 / $599.76	Facility		$159.09	$182.45	$599.76
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $182.45 / $182.45 / $286.39	Professional		$182.45	$182.45	$286.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $209.83 / $244.73 / $276.60	Professional		$209.83	$244.73	$276.60
United Facility/Professional Facility Modifier Low / Median / High Price $182.33 / $182.33 / $182.33	Facility		$182.33	$182.33	$182.33
United Facility/Professional Professional Modifier Low / Median / High Price $182.45 / $182.45 / $237.55	Professional		$182.45	$182.45	$237.55