Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $131.83	Facility		$112.20	$112.20	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $141.25	Professional		$112.20	$112.20	$141.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $131.83 / $213.80	Professional		$112.20	$131.83	$213.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $151.36	Professional		$112.20	$112.20	$151.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $112.20	Facility		$107.15	$107.15	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $158.49	Professional		$112.20	$112.20	$158.49
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $112.20	Facility		$107.15	$107.15	$112.20
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $190.55	Professional		$112.20	$112.20	$190.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $112.20 / $144.54	Professional		$79.43	$112.20	$144.54
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $144.54 / $158.49	Facility		$134.90	$144.54	$158.49
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $144.54 / $794.33	Professional		$123.03	$144.54	$794.33
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $177.83 / $812.83	Professional		$125.89	$177.83	$812.83