Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $127.45 / $276.57 / $30,803.05	Facility		$127.45	$276.57	$30,803.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.45 / $127.50 / $424.41	Professional		$127.45	$127.50	$424.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $137.65 / $205.19 / $318.63	Facility		$137.65	$205.19	$318.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $127.45 / $127.45 / $220.69	Professional		$127.45	$127.45	$220.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $127.45 / $127.45 / $216.67	Facility		$127.45	$127.45	$216.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $127.45 / $127.45 / $172.06	Professional		$127.45	$127.45	$172.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.24 / $120.24 / $127.45	Facility		$120.24	$120.24	$127.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.45 / $127.45 / $276.63	Professional		$127.45	$127.45	$276.63
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $223.18 / $223.18 / $223.18	Facility		$223.18	$223.18	$223.18
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $127.45 / $127.45 / $276.63	Professional		$127.45	$127.45	$276.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $140.19 / $164.32 / $184.80	Professional		$140.19	$164.32	$184.80
United Facility/Professional Professional Modifier Low / Median / High Price $127.45 / $127.45 / $177.30	Professional		$127.45	$127.45	$177.30