Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $140.99 / $305.95 / $453.00	Facility		$140.99	$305.95	$453.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.99 / $142.40 / $352.48	Professional		$140.99	$142.40	$352.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $152.27 / $246.24 / $404.64	Facility		$152.27	$246.24	$404.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.99 / $140.99 / $237.70	Professional		$140.99	$140.99	$237.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $140.99 / $140.99 / $239.68	Facility		$140.99	$140.99	$239.68
CareSource Facility/Professional Professional Modifier Low / Median / High Price $140.99 / $140.99 / $190.34	Professional		$140.99	$140.99	$190.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $133.01 / $133.01 / $140.99	Facility		$133.01	$133.01	$140.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.99 / $140.99 / $233.02	Professional		$140.99	$140.99	$233.02
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $133.01 / $133.01 / $140.99	Facility		$133.01	$133.01	$140.99
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $140.99 / $140.99 / $233.02	Professional		$140.99	$140.99	$233.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $154.47 / $176.23 / $203.62	Professional		$154.47	$176.23	$203.62
United Facility/Professional Professional Modifier Low / Median / High Price $140.99 / $156.94 / $198.09	Professional		$140.99	$156.94	$198.09