Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.97 / $164.86 / $252.98	Facility		$75.97	$164.86	$252.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.97 / $78.25 / $182.32	Professional		$75.97	$78.25	$182.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $82.05 / $132.68 / $218.03	Facility		$82.05	$132.68	$218.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.97 / $75.97 / $144.34	Professional		$75.97	$75.97	$144.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.97 / $75.97 / $129.15	Facility		$75.97	$75.97	$129.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75.97 / $75.97 / $102.56	Professional		$75.97	$75.97	$102.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $71.67 / $71.67 / $75.97	Facility		$71.67	$71.67	$75.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.97 / $75.97 / $121.56	Professional		$75.97	$75.97	$121.56
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $71.67 / $75.97 / $75.97	Facility		$71.67	$75.97	$75.97
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $75.97 / $75.97 / $121.56	Professional		$75.97	$75.97	$121.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $104.80 / $140.86 / $158.70	Professional		$104.80	$140.86	$158.70
United Facility/Professional Facility Modifier Low / Median / High Price $75.97 / $75.97 / $75.97	Facility		$75.97	$75.97	$75.97
United Facility/Professional Professional Modifier Low / Median / High Price $75.97 / $75.97 / $98.91	Professional		$75.97	$75.97	$98.91