Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.80 / $123.80 / $649.00	Facility		$123.80	$123.80	$649.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $123.80 / $127.52	Professional		$123.80	$123.80	$127.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $141.37 / $240.37	Professional		$123.80	$141.37	$240.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $123.80 / $123.80 / $210.46	Facility		$123.80	$123.80	$210.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $123.80 / $167.13	Professional		$123.80	$123.80	$167.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.79 / $116.79 / $123.80	Facility		$116.79	$116.79	$123.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $123.80 / $223.59	Professional		$123.80	$123.80	$223.59
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $229.50 / $229.50 / $229.50	Facility		$229.50	$229.50	$229.50
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $123.80 / $207.87	Professional		$123.80	$123.80	$207.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $50.00 / $141.27	Professional		$40.00	$50.00	$141.27
United Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $123.80 / $159.21	Professional		$123.80	$123.80	$159.21