Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.83 / $359.85 / $503.70	Facility		$165.83	$359.85	$503.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.57 / $165.83 / $414.58	Professional		$163.57	$165.83	$414.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $179.10 / $289.62 / $475.93	Facility		$179.10	$289.62	$475.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $165.83 / $279.58	Professional		$165.83	$165.83	$279.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $165.83 / $165.83 / $281.91	Facility		$165.83	$165.83	$281.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $165.83 / $223.87	Professional		$165.83	$165.83	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $156.44 / $156.44 / $165.83	Facility		$156.44	$156.44	$165.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $165.83 / $240.95	Professional		$165.83	$165.83	$240.95
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $155.97 / $156.44 / $165.83	Facility		$155.97	$156.44	$165.83
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $165.83 / $240.95	Professional		$165.83	$165.83	$240.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $179.70 / $207.28 / $236.88	Professional		$179.70	$207.28	$236.88
United Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $165.83 / $179.36	Professional		$165.83	$165.83	$179.36