Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.91 / $158.91 / $271.00	Facility		$158.91	$158.91	$271.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $158.91 / $163.68	Professional		$158.91	$158.91	$163.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $238.38 / $371.87 / $1,032.98	Facility		$238.38	$371.87	$1,032.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $158.91 / $262.20	Professional		$158.91	$158.91	$262.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $131.90 / $158.91 / $230.43	Facility		$131.90	$158.91	$230.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $111.24 / $158.91 / $166.87	Professional		$111.24	$158.91	$166.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $149.91 / $152.91 / $158.91	Facility		$149.91	$152.91	$158.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $158.91 / $189.47	Professional		$158.91	$158.91	$189.47
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $152.91 / $152.91 / $158.91	Facility		$152.91	$152.91	$158.91
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $158.91 / $226.97	Professional		$158.91	$158.91	$226.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $148.76 / $174.81 / $222.48	Professional		$148.76	$174.81	$222.48
United Facility/Professional Professional Modifier Low / Median / High Price $63.57 / $158.91 / $221.07	Professional		$63.57	$158.91	$221.07