Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.29 / $64.29 / $208.00	Facility		$64.29	$64.29	$208.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.24 / $64.29 / $73.43	Professional		$59.24	$64.29	$73.43
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.40 / $131.66 / $341.15	Facility		$112.40	$131.66	$341.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.00 / $66.73 / $155.61	Professional		$58.00	$66.73	$155.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $89.78 / $119.70 / $162.58	Facility		$89.78	$119.70	$162.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $78.27 / $110.55 / $256.30	Professional		$78.27	$110.55	$256.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.33 / $84.33 / $145.91	Facility		$84.33	$84.33	$145.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.56 / $61.56 / $84.33	Professional		$61.56	$61.56	$84.33
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $84.33 / $84.33 / $84.33	Facility		$84.33	$84.33	$84.33
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $61.56 / $84.33 / $84.33	Professional		$61.56	$84.33	$84.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $51.45 / $70.75 / $92.75	Professional		$51.45	$70.75	$92.75
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $57.22 / $86.74	Professional		$39.81	$57.22	$86.74