Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.93 / $137.93 / $326.00	Facility		$137.93	$137.93	$326.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $142.06	Professional		$137.93	$137.93	$142.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $158.61 / $268.56	Professional		$137.93	$158.61	$268.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $137.93 / $137.93 / $208.27	Facility		$137.93	$137.93	$208.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $186.21	Professional		$137.93	$137.93	$186.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $130.12 / $130.12 / $137.93	Facility		$130.12	$130.12	$137.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $137.93	Professional		$137.93	$137.93	$137.93
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $128.08 / $128.08 / $128.08	Facility		$128.08	$128.08	$128.08
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $162.65	Professional		$137.93	$137.93	$162.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $119.46 / $151.72 / $179.30	Professional		$119.46	$151.72	$179.30
United Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $179.58	Professional		$137.93	$137.93	$179.58