Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.88 / $134.88 / $279.00	Facility		$134.88	$134.88	$279.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $134.88 / $138.93	Professional		$134.88	$134.88	$138.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $155.12 / $261.89	Professional		$134.88	$155.12	$261.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $134.88 / $134.88 / $203.68	Facility		$134.88	$134.88	$203.68
CareSource Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $134.88 / $182.10	Professional		$134.88	$134.88	$182.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $127.25 / $127.25 / $134.88	Facility		$127.25	$127.25	$134.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $134.88 / $137.19	Professional		$134.88	$134.88	$137.19
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $140.35 / $140.35 / $140.35	Facility		$140.35	$140.35	$140.35
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $134.88 / $159.06	Professional		$134.88	$134.88	$159.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $137.19 / $168.61 / $197.84	Professional		$137.19	$168.61	$197.84
United Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $134.88 / $175.63	Professional		$134.88	$134.88	$175.63