Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.04 / $64.04 / $352.00	Facility		$64.04	$64.04	$352.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.04 / $69.64 / $107.64	Professional		$64.04	$69.64	$107.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.62 / $131.93 / $341.83	Facility		$112.62	$131.93	$341.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.51 / $109.83 / $194.70	Professional		$95.51	$109.83	$194.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $89.96 / $120.10 / $167.92	Facility		$89.96	$120.10	$167.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $83.96 / $119.94 / $256.82	Professional		$83.96	$119.94	$256.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $133.72 / $133.72 / $182.46	Facility		$133.72	$133.72	$182.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.62 / $97.62 / $160.50	Professional		$97.62	$97.62	$160.50
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $133.72 / $133.72 / $133.72	Facility		$133.72	$133.72	$133.72
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $97.62 / $133.72 / $133.72	Professional		$97.62	$133.72	$133.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $124.00 / $170.50 / $223.52	Professional		$124.00	$170.50	$223.52
United Facility/Professional Professional Modifier Low / Median / High Price $65.12 / $96.81 / $141.90	Professional		$65.12	$96.81	$141.90