Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.90 / $177.72 / $272.73	Facility		$81.90	$177.72	$272.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $82.72 / $106.06	Professional		$81.90	$82.72	$106.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $88.45 / $140.46 / $233.42	Facility		$88.45	$140.46	$233.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $91.72 / $138.08	Professional		$81.90	$91.72	$138.08
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $194.10 / $194.10 / $194.10	Facility		$194.10	$194.10	$194.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $81.90 / $81.90 / $123.01	Facility		$81.90	$81.90	$123.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $81.90 / $110.57	Professional		$81.90	$81.90	$110.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.26 / $81.90 / $85.98	Facility		$77.26	$81.90	$85.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $81.90 / $104.39	Professional		$81.90	$81.90	$104.39
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $77.26 / $81.90 / $114.26	Facility		$77.26	$81.90	$114.26
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $81.90 / $115.90	Professional		$81.90	$81.90	$115.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.99 / $114.66 / $171.99	Professional		$85.99	$114.66	$171.99
United Facility/Professional Professional Modifier Low / Median / High Price $81.73 / $81.90 / $99.10	Professional		$81.73	$81.90	$99.10