Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.26 / $171.99 / $263.94	Facility		$79.26	$171.99	$263.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.26 / $80.18 / $198.15	Professional		$79.26	$80.18	$198.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.60 / $138.43 / $227.48	Facility		$85.60	$138.43	$227.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.26 / $79.26 / $133.63	Professional		$79.26	$79.26	$133.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $79.26 / $79.26 / $134.74	Facility		$79.26	$79.26	$134.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.26 / $79.26 / $107.00	Professional		$79.26	$79.26	$107.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.77 / $74.77 / $79.26	Facility		$74.77	$74.77	$79.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.26 / $79.26 / $118.76	Professional		$79.26	$79.26	$118.76
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $74.77 / $74.77 / $79.26	Facility		$74.77	$74.77	$79.26
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $79.26 / $79.26 / $118.76	Professional		$79.26	$79.26	$118.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.18 / $99.23 / $114.92	Professional		$87.18	$99.23	$114.92
United Facility/Professional Facility Modifier Low / Median / High Price $79.20 / $79.20 / $79.20	Facility		$79.20	$79.20	$79.20
United Facility/Professional Professional Modifier Low / Median / High Price $79.26 / $79.26 / $110.26	Professional		$79.26	$79.26	$110.26