Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.73 / $151.31 / $446.00	Facility		$69.73	$151.31	$446.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $70.43 / $150.24	Professional		$69.73	$70.43	$150.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.60 / $163.16 / $453.25	Facility		$104.60	$163.16	$453.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $69.73 / $115.05	Professional		$69.73	$69.73	$115.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $59.27 / $69.73 / $101.11	Facility		$59.27	$69.73	$101.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $48.81 / $69.73 / $73.22	Professional		$48.81	$69.73	$73.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.78 / $69.73 / $95.63	Facility		$65.78	$69.73	$95.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $69.73 / $112.50	Professional		$69.73	$69.73	$112.50
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $65.78 / $69.73 / $203.34	Facility		$65.78	$69.73	$203.34
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $69.73 / $112.50	Professional		$69.73	$69.73	$112.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.70 / $87.45 / $115.27	Professional		$76.70	$87.45	$115.27
United Facility/Professional Professional Modifier Low / Median / High Price $27.89 / $69.73 / $99.02	Professional		$27.89	$69.73	$99.02