Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $121.78 / $121.78 / $814.00	Facility		$121.78	$121.78	$814.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.22 / $121.78 / $148.25	Professional		$112.22	$121.78	$148.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $212.89 / $249.39 / $646.15	Facility		$212.89	$249.39	$646.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.60 / $127.06 / $294.73	Professional		$110.60	$127.06	$294.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $170.04 / $226.72 / $306.07	Facility		$170.04	$226.72	$306.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $147.37 / $204.05 / $485.45	Professional		$147.37	$204.05	$485.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $135.51 / $135.51 / $284.00	Facility		$135.51	$135.51	$284.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.92 / $98.92 / $173.11	Professional		$98.92	$98.92	$173.11
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $135.51 / $135.51 / $135.51	Facility		$135.51	$135.51	$135.51
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $98.92 / $135.51 / $135.51	Professional		$98.92	$135.51	$135.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.17 / $132.24 / $173.36	Professional		$96.17	$132.24	$173.36
United Facility/Professional Professional Modifier Low / Median / High Price $75.41 / $109.58 / $163.01	Professional		$75.41	$109.58	$163.01