Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.15 / $55.15 / $155.00	Facility		$55.15	$55.15	$155.00
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 / $55.85 / $133.49	Professional		$50.10	$55.85	$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 $69.65 / $69.65 / $121.01	Facility		$69.65	$69.65	$121.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.84 / $50.84 / $69.65	Professional		$50.84	$50.84	$69.65
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $69.65 / $69.65 / $69.65	Facility		$69.65	$69.65	$69.65
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $50.84 / $69.65 / $69.65	Professional		$50.84	$69.65	$69.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.32 / $76.07 / $99.73	Professional		$55.32	$76.07	$99.73
United Facility/Professional Professional Modifier Low / Median / High Price $34.15 / $48.96 / $66.68	Professional		$34.15	$48.96	$66.68