Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $121.30 / $121.30 / $390.00	Facility		$121.30	$121.30	$390.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.76 / $121.30 / $176.53	Professional		$108.76	$121.30	$176.53
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $212.06 / $248.42 / $643.64	Facility		$212.06	$248.42	$643.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.00 / $132.00 / $297.76	Professional		$110.00	$132.00	$297.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $169.38 / $225.84 / $304.88	Facility		$169.38	$225.84	$304.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $146.80 / $225.84 / $483.57	Professional		$146.80	$225.84	$483.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $141.12 / $141.12 / $310.16	Facility		$141.12	$141.12	$310.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.02 / $103.02 / $187.78	Professional		$103.02	$103.02	$187.78
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $141.12 / $141.12 / $141.12	Facility		$141.12	$141.12	$141.12
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $103.02 / $141.12 / $141.12	Professional		$103.02	$141.12	$141.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.80 / $131.72 / $172.69	Professional		$95.80	$131.72	$172.69
United Facility/Professional Facility Modifier Low / Median / High Price $150.50 / $150.50 / $150.50	Facility		$150.50	$150.50	$150.50
United Facility/Professional Professional Modifier Low / Median / High Price $75.11 / $112.67 / $169.55	Professional		$75.11	$112.67	$169.55