Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $111.15 / $392.00	Facility		$111.15	$111.15	$392.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $114.49	Professional		$111.15	$111.15	$114.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $133.38 / $234.52	Professional		$111.15	$133.38	$234.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $111.15 / $188.96	Facility		$111.15	$111.15	$188.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $150.05	Professional		$111.15	$111.15	$150.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.86 / $104.86 / $111.15	Facility		$104.86	$104.86	$111.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $214.78	Professional		$111.15	$111.15	$214.78
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $402.90 / $402.90 / $402.90	Facility		$402.90	$402.90	$402.90
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $214.78	Professional		$111.15	$111.15	$214.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $122.26 / $365.66	Professional		$50.00	$122.26	$365.66
United Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $144.72	Professional		$111.15	$111.15	$144.72