Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.15 / $55.15 / $186.00	Facility		$55.15	$55.15	$186.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.28 / $55.15 / $63.20	Professional		$48.28	$55.15	$63.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $96.43 / $112.96 / $292.67	Facility		$96.43	$112.96	$292.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.10 / $53.72 / $133.49	Professional		$50.10	$53.72	$133.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $77.02 / $102.69 / $138.63	Facility		$77.02	$102.69	$138.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.12 / $92.93 / $219.88	Professional		$67.12	$92.93	$219.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.32 / $57.32 / $121.01	Facility		$57.32	$57.32	$121.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.84 / $41.84 / $73.23	Professional		$41.84	$41.84	$73.23
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $57.32 / $57.32 / $57.32	Facility		$57.32	$57.32	$57.32
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $41.84 / $57.32 / $57.32	Professional		$41.84	$57.32	$57.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.37 / $21.14 / $27.71	Professional		$15.37	$21.14	$27.71
United Facility/Professional Facility Modifier Low / Median / High Price $103.97 / $103.97 / $122.32	Facility		$103.97	$103.97	$122.32
United Facility/Professional Professional Modifier Low / Median / High Price $34.15 / $48.33 / $70.52	Professional		$34.15	$48.33	$70.52