Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.70 / $137.54 / $211.06	Facility		$50.70	$137.54	$211.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.70 / $50.70 / $140.94	Professional		$50.70	$50.70	$140.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.76 / $42.04 / $123.60	Facility		$22.76	$42.04	$123.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.60 / $24.09 / $68.56	Professional		$22.60	$24.09	$68.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6.19 / $6.19 / $10.52	Facility		$6.19	$6.19	$10.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6.19 / $6.19 / $6.19	Professional		$6.19	$6.19	$6.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.87 / $53.87 / $53.87	Facility		$53.87	$53.87	$53.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.87 / $53.87 / $84.77	Professional		$53.87	$53.87	$84.77
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $53.87 / $53.87 / $53.87	Facility		$53.87	$53.87	$53.87
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $53.87 / $53.87 / $84.77	Professional		$53.87	$53.87	$84.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.86 / $28.25 / $32.77	Professional		$24.86	$28.25	$32.77
United Facility/Professional Facility Modifier Low / Median / High Price $82.37 / $82.37 / $82.37	Facility		$82.37	$82.37	$82.37
United Facility/Professional Professional Modifier Low / Median / High Price $52.82 / $52.82 / $69.19	Professional		$52.82	$52.82	$69.19