Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.84 / $124.84 / $429.00	Facility		$124.84	$124.84	$429.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.63 / $124.84 / $174.92	Professional		$111.63	$124.84	$174.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $218.25 / $255.67 / $662.43	Facility		$218.25	$255.67	$662.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.37 / $135.74 / $305.63	Professional		$113.37	$135.74	$305.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $173.85 / $232.43 / $313.77	Facility		$173.85	$232.43	$313.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $151.08 / $209.19 / $497.68	Professional		$151.08	$209.19	$497.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.84 / $144.84 / $301.44	Facility		$144.84	$144.84	$301.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.73 / $105.73 / $193.25	Professional		$105.73	$105.73	$193.25
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $144.84 / $144.84 / $144.84	Facility		$144.84	$144.84	$144.84
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $105.73 / $126.69 / $144.84	Professional		$105.73	$126.69	$144.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.58 / $135.55 / $177.71	Professional		$98.58	$135.55	$177.71
United Facility/Professional Professional Modifier Low / Median / High Price $77.30 / $115.64 / $168.44	Professional		$77.30	$115.64	$168.44