Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $325.50 / $499.50	Facility		$120.00	$325.50	$499.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $120.00 / $333.60	Professional		$120.00	$120.00	$333.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $135.00 / $229.46 / $377.06	Facility		$135.00	$229.46	$377.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $220.00 / $275.00 / $401.50	Professional		$220.00	$275.00	$401.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $397.24 / $516.41 / $655.45	Facility		$397.24	$516.41	$655.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Facility		$127.50	$127.50	$127.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $200.60	Professional		$127.50	$127.50	$200.60
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Facility		$127.50	$127.50	$127.50
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $200.60	Professional		$127.50	$127.50	$200.60
United Facility/Professional Professional Modifier Low / Median / High Price $125.00 / $125.00 / $162.75	Professional		$125.00	$125.00	$162.75