Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.00 / $171.43 / $3,486.30	Facility		$79.00	$171.43	$3,486.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.45 / $79.00 / $104.59	Professional		$78.45	$79.00	$104.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.32 / $127.19 / $197.50	Facility		$85.32	$127.19	$197.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $89.27 / $133.19	Professional		$79.00	$89.27	$133.19
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $187.23 / $187.23 / $187.23	Facility		$187.23	$187.23	$187.23
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $103.49 / $103.49 / $103.49	Professional		$103.49	$103.49	$103.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $79.00 / $79.00 / $118.64	Facility		$79.00	$79.00	$118.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $79.00 / $106.65	Professional		$79.00	$79.00	$106.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.52 / $79.00 / $87.85	Facility		$74.52	$79.00	$87.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $79.00 / $108.00	Professional		$79.00	$79.00	$108.00
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $74.52 / $79.00 / $174.87	Facility		$74.52	$79.00	$174.87
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $79.00 / $111.79	Professional		$79.00	$79.00	$111.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.45 / $90.22 / $109.05	Professional		$78.45	$90.22	$109.05
United Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $79.00 / $97.20	Professional		$79.00	$79.00	$97.20