Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.79 / $85.79 / $249.00	Facility		$85.79	$85.79	$249.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.08 / $85.79 / $96.21	Professional		$65.08	$85.79	$96.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $149.99 / $175.70 / $455.23	Facility		$149.99	$175.70	$455.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.26 / $79.04 / $207.64	Professional		$77.26	$79.04	$207.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $103.82 / $159.72 / $215.64	Facility		$103.82	$159.72	$215.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $103.82 / $143.76 / $342.01	Professional		$103.82	$143.76	$342.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $103.32 / $103.32 / $174.28	Facility		$103.32	$103.32	$174.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.42 / $75.42 / $131.99	Professional		$75.42	$75.42	$131.99
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $103.32 / $103.32 / $103.32	Facility		$103.32	$103.32	$103.32
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $75.42 / $103.32 / $103.32	Professional		$75.42	$103.32	$103.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $67.75 / $93.15 / $122.13	Professional		$67.75	$93.15	$122.13
United Facility/Professional Professional Modifier Low / Median / High Price $49.53 / $75.01 / $101.43	Professional		$49.53	$75.01	$101.43