Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.89 / $173.30 / $265.93	Facility		$72.89	$173.30	$265.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.01 / $79.86 / $95.83	Professional		$64.01	$79.86	$95.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $86.25 / $136.96 / $227.60	Facility		$86.25	$136.96	$227.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $91.20 / $141.13	Professional		$79.86	$91.20	$141.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $79.86 / $79.86 / $120.59	Facility		$79.86	$79.86	$120.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $79.86 / $107.81	Professional		$79.86	$79.86	$107.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.34 / $79.86 / $107.65	Facility		$75.34	$79.86	$107.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $79.86 / $125.15	Professional		$79.86	$79.86	$125.15
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $75.34 / $79.86 / $115.88	Facility		$75.34	$79.86	$115.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $79.86 / $125.15	Professional		$79.86	$79.86	$125.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.38 / $79.86 / $103.81	Professional		$63.38	$79.86	$103.81
United Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $81.86 / $98.97	Professional		$79.86	$81.86	$98.97