Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $207.13 / $449.47 / $689.74	Facility		$207.13	$449.47	$689.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $207.13 / $263.85	Professional		$207.13	$207.13	$263.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $223.70 / $355.23 / $590.32	Facility		$223.70	$355.23	$590.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $231.98 / $349.22	Professional		$207.13	$231.98	$349.22
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $490.90 / $490.90 / $490.90	Facility		$490.90	$490.90	$490.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $207.13 / $207.13 / $341.76	Facility		$207.13	$207.13	$341.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $207.13 / $279.63	Professional		$207.13	$207.13	$279.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $195.40 / $206.81 / $207.13	Facility		$195.40	$206.81	$207.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $207.13 / $263.79	Professional		$207.13	$207.13	$263.79
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $195.40 / $207.13 / $295.06	Facility		$195.40	$207.13	$295.06
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $207.13 / $293.10	Professional		$207.13	$207.13	$293.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $206.13 / $237.04 / $297.26	Professional		$206.13	$237.04	$297.26
United Facility/Professional Facility Modifier Low / Median / High Price $207.00 / $207.00 / $207.00	Facility		$207.00	$207.00	$207.00
United Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $219.56 / $253.55	Professional		$207.13	$219.56	$253.55