Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.70 / $106.70 / $479.00	Facility		$106.70	$106.70	$479.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $109.90	Professional		$106.70	$106.70	$109.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $123.16 / $207.16	Professional		$106.70	$123.16	$207.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $106.70 / $106.70 / $181.39	Facility		$106.70	$106.70	$181.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $144.05	Professional		$106.70	$106.70	$144.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.66 / $100.66 / $106.70	Facility		$100.66	$100.66	$106.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $150.99	Professional		$106.70	$106.70	$150.99
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $479.40 / $479.40 / $479.40	Facility		$479.40	$479.40	$479.40
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $150.99	Professional		$106.70	$106.70	$150.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.25 / $106.70 / $138.71	Professional		$41.25	$106.70	$138.71
United Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $136.36	Professional		$106.70	$106.70	$136.36