Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $210.27 / $210.27 / $811.00	Facility		$210.27	$210.27	$811.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.43 / $210.27 / $267.33	Professional		$172.43	$210.27	$267.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $367.61 / $430.64 / $1,115.75	Facility		$367.61	$430.64	$1,115.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.98 / $209.66 / $508.93	Professional		$190.98	$209.66	$508.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $268.52 / $391.49 / $528.51	Facility		$268.52	$391.49	$528.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $254.47 / $352.34 / $838.26	Professional		$254.47	$352.34	$838.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $227.07 / $227.07 / $460.43	Facility		$227.07	$227.07	$460.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.76 / $165.76 / $227.07	Professional		$165.76	$165.76	$227.07
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $227.07 / $227.07 / $227.07	Facility		$227.07	$227.07	$227.07
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $165.76 / $227.07 / $227.07	Professional		$165.76	$227.07	$227.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $168.88 / $232.22 / $304.44	Professional		$168.88	$232.22	$304.44
United Facility/Professional Professional Modifier Low / Median / High Price $130.21 / $188.34 / $270.44	Professional		$130.21	$188.34	$270.44