Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.53 / $193.87 / $297.50	Facility		$104.53	$193.87	$297.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $90.24 / $139.41	Professional		$89.34	$90.24	$139.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $96.49 / $153.22 / $254.62	Facility		$96.49	$153.22	$254.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $102.08 / $152.22	Professional		$89.34	$102.08	$152.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $89.34 / $89.34 / $134.19	Facility		$89.34	$89.34	$134.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $120.61	Professional		$89.34	$89.34	$120.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.29 / $89.34 / $137.66	Facility		$84.29	$89.34	$137.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $154.19	Professional		$89.34	$89.34	$154.19
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $84.29 / $89.34 / $282.77	Facility		$84.29	$89.34	$282.77
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $154.19	Professional		$89.34	$89.34	$154.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.27 / $118.75 / $151.64	Professional		$98.27	$118.75	$151.64
United Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $110.72	Professional		$89.34	$89.34	$110.72