Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.47 / $120.37 / $184.72	Facility		$55.47	$120.37	$184.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.30 / $55.47 / $70.16	Professional		$55.30	$55.47	$70.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $59.91 / $95.13 / $158.09	Facility		$59.91	$95.13	$158.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.47 / $62.12 / $93.52	Professional		$55.47	$62.12	$93.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $55.47 / $55.47 / $83.21	Facility		$55.47	$55.47	$83.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $55.47 / $55.47 / $74.88	Professional		$55.47	$55.47	$74.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.33 / $54.38 / $55.47	Facility		$52.33	$54.38	$55.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.47 / $55.47 / $70.34	Professional		$55.47	$55.47	$70.34
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $54.14 / $83.92 / $200.19	Facility		$54.14	$83.92	$200.19
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $55.47 / $55.47 / $78.50	Professional		$55.47	$55.47	$78.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $59.81 / $61.01	Professional		$30.00	$59.81	$61.01
United Facility/Professional Facility Modifier Low / Median / High Price $55.47 / $55.47 / $55.47	Facility		$55.47	$55.47	$55.47
United Facility/Professional Professional Modifier Low / Median / High Price $53.38 / $55.47 / $64.17	Professional		$53.38	$55.47	$64.17