Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $45.00 / $1,150.00	Facility		$45.00	$45.00	$1,150.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $45.00 / $45.00	Professional		$45.00	$45.00	$45.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $193.00 / $223.88 / $1,078.66	Professional		$193.00	$223.88	$1,078.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $193.74 / $251.86 / $339.05	Facility		$193.74	$251.86	$339.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $125.93 / $164.68 / $203.43	Professional		$125.93	$164.68	$203.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $379.93 / $379.93	Facility		$70.00	$379.93	$379.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $277.35 / $277.35 / $379.93	Professional		$277.35	$277.35	$379.93
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $379.93 / $379.93 / $379.93	Facility		$379.93	$379.93	$379.93
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $277.35 / $379.93 / $379.93	Professional		$277.35	$379.93	$379.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $143.51 / $157.86 / $165.03	Professional		$143.51	$157.86	$165.03
United Facility/Professional Professional Modifier Low / Median / High Price $4,790.84 / $4,790.84 / $4,790.84	Professional		$4,790.84	$4,790.84	$4,790.84