Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $177.83 / $263.03	Facility		$83.18	$177.83	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $87.10 / $107.15	Professional		$83.18	$87.10	$107.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $186.21 / $575.44	Facility		$95.50	$186.21	$575.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $87.10 / $141.25	Professional		$75.86	$87.10	$141.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Professional		$89.13	$89.13	$89.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $169.82	Facility		$89.13	$89.13	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $104.71	Professional		$89.13	$89.13	$104.71
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $100.00	Facility		$89.13	$89.13	$100.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $104.71	Professional		$89.13	$89.13	$104.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $134.90	Professional		$89.13	$89.13	$134.90
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $114.82 / $213.80	Professional		$93.33	$114.82	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $87.10 / $97.72	Professional		$83.18	$87.10	$97.72