Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.99 / $86.99 / $240.00	Facility		$86.99	$86.99	$240.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.90 / $86.99 / $92.50	Professional		$63.90	$86.99	$92.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $152.09 / $178.17 / $461.61	Facility		$152.09	$178.17	$461.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.70 / $79.14 / $210.56	Professional		$77.70	$79.14	$210.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $105.28 / $161.97 / $218.66	Facility		$105.28	$161.97	$218.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $105.28 / $145.77 / $346.81	Professional		$105.28	$145.77	$346.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.22 / $106.22 / $179.38	Facility		$106.22	$106.22	$179.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.54 / $77.54 / $134.66	Professional		$77.54	$77.54	$134.66
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $106.22 / $106.22 / $106.22	Facility		$106.22	$106.22	$106.22
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $77.54 / $106.22 / $106.22	Professional		$77.54	$106.22	$106.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $68.68 / $94.44 / $123.81	Professional		$68.68	$94.44	$123.81
United Facility/Professional Facility Modifier Low / Median / High Price $44.82 / $65.59 / $129.58	Facility		$44.82	$65.59	$129.58
United Facility/Professional Professional Modifier Low / Median / High Price $49.81 / $73.48 / $102.81	Professional		$49.81	$73.48	$102.81