Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $61,659.50 / $89,125.09	Facility		$67.61	$61,659.50	$89,125.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $61.66 / $128.82	Professional		$58.88	$61.66	$128.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $102.33 / $213.80	Facility		$64.57	$102.33	$213.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $66.07 / $104.71	Professional		$58.88	$66.07	$104.71
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Facility		$79.43	$79.43	$79.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Facility		$58.88	$58.88	$58.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Professional		$79.43	$79.43	$79.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $56.23 / $58.88	Facility		$56.23	$56.23	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $104.71	Professional		$58.88	$58.88	$104.71
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $58.88 / $128.82	Facility		$56.23	$58.88	$128.82
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $104.71	Professional		$58.88	$58.88	$104.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $74.13 / $85.11	Professional		$58.88	$74.13	$85.11
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $100.00 / $138.04	Professional		$60.26	$100.00	$138.04
United Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Facility		$58.88	$58.88	$58.88
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $64.57	Professional		$58.88	$58.88	$64.57