Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $122.90 / $122.90 / $245.00	Facility		$122.90	$122.90	$245.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.33 / $122.90 / $130.66	Professional		$100.33	$122.90	$130.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $214.85 / $251.69 / $652.11	Facility		$214.85	$251.69	$652.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.91 / $111.61 / $297.45	Professional		$104.91	$111.61	$297.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $154.94 / $228.81 / $308.89	Facility		$154.94	$228.81	$308.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $148.72 / $205.93 / $489.93	Professional		$148.72	$205.93	$489.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.95 / $111.95 / $233.28	Facility		$111.95	$111.95	$233.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.72 / $81.72 / $143.02	Professional		$81.72	$81.72	$143.02
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $111.95 / $111.95 / $111.95	Facility		$111.95	$111.95	$111.95
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $81.72 / $111.94 / $111.95	Professional		$81.72	$111.94	$111.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $100.06 / $137.58 / $180.37	Professional		$100.06	$137.58	$180.37
United Facility/Professional Professional Modifier Low / Median / High Price $67.31 / $106.31 / $145.24	Professional		$67.31	$106.31	$145.24