Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.23 / $215.36 / $276.00	Facility		$83.23	$215.36	$276.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.23 / $83.23 / $231.38	Professional		$83.23	$83.23	$231.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $130.05 / $202.88 / $563.54	Facility		$130.05	$202.88	$563.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.70 / $91.90 / $156.47	Professional		$86.70	$91.90	$156.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $71.90 / $71.90 / $118.64	Facility		$71.90	$71.90	$118.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $71.90 / $71.90 / $71.90	Professional		$71.90	$71.90	$71.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.43 / $88.43 / $88.43	Facility		$88.43	$88.43	$88.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $88.43 / $139.13	Professional		$88.43	$88.43	$139.13
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $88.43 / $88.43 / $88.43	Facility		$88.43	$88.43	$88.43
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $88.43 / $139.13	Professional		$88.43	$88.43	$139.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $101.09 / $114.87 / $133.25	Professional		$101.09	$114.87	$133.25
United Facility/Professional Professional Modifier Low / Median / High Price $86.70 / $86.70 / $108.38	Professional		$86.70	$86.70	$108.38