Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.02 / $65.02 / $204.00	Facility		$65.02	$65.02	$204.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.90 / $65.02 / $74.48	Professional		$56.90	$65.02	$74.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $113.68 / $133.16 / $345.02	Facility		$113.68	$133.16	$345.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.06 / $64.81 / $159.79	Professional		$59.06	$64.81	$159.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $90.80 / $121.06 / $163.43	Facility		$90.80	$121.06	$163.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.09 / $109.52 / $259.20	Professional		$79.09	$109.52	$259.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.30 / $81.30 / $142.61	Facility		$81.30	$81.30	$142.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.35 / $59.35 / $100.66	Professional		$59.35	$59.35	$100.66
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $81.30 / $81.30 / $81.30	Facility		$81.30	$81.30	$81.30
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $59.35 / $81.30 / $81.30	Professional		$59.35	$81.30	$81.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $46.13 / $63.43 / $83.16	Professional		$46.13	$63.43	$83.16
United Facility/Professional Professional Modifier Low / Median / High Price $40.26 / $56.85 / $81.19	Professional		$40.26	$56.85	$81.19