Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.19 / $120.19 / $315.00	Facility		$120.19	$120.19	$315.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.48 / $120.19 / $165.10	Professional		$115.48	$120.19	$165.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $231.13 / $270.75 / $701.50	Facility		$231.13	$270.75	$701.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.31 / $137.37 / $319.98	Professional		$123.31	$137.37	$319.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $176.63 / $246.14 / $332.29	Facility		$176.63	$246.14	$332.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $159.99 / $221.53 / $527.03	Professional		$159.99	$221.53	$527.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $159.22 / $159.22 / $283.99	Facility		$159.22	$159.22	$283.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.23 / $116.23 / $203.40	Professional		$116.23	$116.23	$203.40
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $159.22 / $159.22 / $159.22	Facility		$159.22	$159.22	$159.22
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $116.23 / $159.22 / $159.22	Professional		$116.23	$159.22	$159.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $104.40 / $143.56 / $188.20	Professional		$104.40	$143.56	$188.20
United Facility/Professional Professional Modifier Low / Median / High Price $81.86 / $121.70 / $172.12	Professional		$81.86	$121.70	$172.12