Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.52 / $138.66 / $228.24	Facility		$71.52	$138.66	$228.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $74.12 / $178.80	Professional		$71.52	$74.12	$178.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.28 / $167.36 / $464.88	Facility		$107.28	$167.36	$464.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $71.52 / $135.88	Professional		$71.52	$71.52	$135.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $71.52 / $73.39 / $107.45	Facility		$71.52	$73.39	$107.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $73.39 / $96.55	Professional		$71.52	$73.39	$96.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.47 / $67.47 / $71.52	Facility		$67.47	$67.47	$71.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $71.52 / $152.46	Professional		$71.52	$71.52	$152.46
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $71.52 / $152.46	Professional		$71.52	$71.52	$152.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.72 / $92.45 / $106.41	Professional		$80.72	$92.45	$106.41
United Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $71.52 / $100.49	Professional		$71.52	$71.52	$100.49