Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $136.66 / $296.57 / $494.75	Facility		$136.66	$296.57	$494.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $136.66 / $181.60	Professional		$136.66	$136.66	$181.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.60 / $234.39 / $389.51	Facility		$147.60	$234.39	$389.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $155.80 / $230.42	Professional		$136.66	$155.80	$230.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $136.66 / $136.66 / $205.67	Facility		$136.66	$136.66	$205.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $136.66 / $184.50	Professional		$136.66	$136.66	$184.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.93 / $135.60 / $136.66	Facility		$128.93	$135.60	$136.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $136.66 / $171.74	Professional		$136.66	$136.66	$171.74
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $128.93 / $136.66 / $206.03	Facility		$128.93	$136.66	$206.03
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $136.66 / $193.40	Professional		$136.66	$136.66	$193.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $136.22 / $156.66 / $192.45	Professional		$136.22	$156.66	$192.45
United Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $136.66 / $165.37	Professional		$136.66	$136.66	$165.37