Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.84 / $464.03 / $660.44	Facility		$213.84	$464.03	$660.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.84 / $215.97 / $293.66	Professional		$213.84	$215.97	$293.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $230.95 / $373.47 / $613.72	Facility		$230.95	$373.47	$613.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.84 / $213.84 / $370.28	Professional		$213.84	$213.84	$370.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $213.84 / $213.84 / $363.53	Facility		$213.84	$213.84	$363.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $213.84 / $213.84 / $288.68	Professional		$213.84	$213.84	$288.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $201.74 / $201.74 / $213.84	Facility		$201.74	$201.74	$213.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.84 / $213.84 / $318.87	Professional		$213.84	$213.84	$318.87
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $213.84 / $213.84 / $318.87	Professional		$213.84	$213.84	$318.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $233.59 / $267.30 / $307.92	Professional		$233.59	$267.30	$307.92
United Facility/Professional Facility Modifier Low / Median / High Price $213.84 / $213.84 / $213.84	Facility		$213.84	$213.84	$213.84
United Facility/Professional Professional Modifier Low / Median / High Price $213.84 / $213.84 / $231.29	Professional		$213.84	$213.84	$231.29