Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $130.10 / $130.10 / $326.00	Facility		$130.10	$130.10	$326.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.99 / $130.10 / $152.16	Professional		$97.99	$130.10	$152.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $250.19 / $293.08 / $759.35	Facility		$250.19	$293.08	$759.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.02 / $133.47 / $346.37	Professional		$120.02	$133.47	$346.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $169.86 / $266.44 / $359.69	Facility		$169.86	$266.44	$359.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $173.19 / $239.80 / $570.50	Professional		$173.19	$239.80	$570.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $172.35 / $172.35 / $257.12	Facility		$172.35	$172.35	$257.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.82 / $125.82 / $221.54	Professional		$125.82	$125.82	$221.54
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $172.35 / $172.35 / $172.35	Facility		$172.35	$172.35	$172.35
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $125.82 / $172.35 / $172.35	Professional		$125.82	$172.35	$172.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $113.02 / $155.40 / $203.73	Professional		$113.02	$155.40	$203.73
United Facility/Professional Facility Modifier Low / Median / High Price $90.10 / $150.02 / $213.15	Facility		$90.10	$150.02	$213.15
United Facility/Professional Professional Modifier Low / Median / High Price $83.08 / $132.91 / $169.12	Professional		$83.08	$132.91	$169.12