Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.20 / $147.99 / $227.11	Facility		$68.20	$147.99	$227.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $68.88 / $91.71	Professional		$68.20	$68.88	$91.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $73.66 / $116.96 / $194.37	Facility		$73.66	$116.96	$194.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $77.88 / $119.35	Professional		$68.20	$77.88	$119.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $68.20 / $68.20 / $102.60	Facility		$68.20	$68.20	$102.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $68.20 / $92.07	Professional		$68.20	$68.20	$92.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.34 / $68.20 / $222.81	Facility		$64.34	$68.20	$222.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $68.20 / $113.40	Professional		$68.20	$68.20	$113.40
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $64.34 / $68.20 / $260.87	Facility		$64.34	$68.20	$260.87
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $68.20 / $118.14	Professional		$68.20	$68.20	$118.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.48 / $77.38 / $95.48	Professional		$65.48	$77.38	$95.48
United Facility/Professional Facility Modifier Low / Median / High Price $72.63 / $72.63 / $72.63	Facility		$72.63	$72.63	$72.63
United Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $68.20 / $83.51	Professional		$68.20	$68.20	$83.51