Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $120.00 / $120.00	Facility		$120.00	$120.00	$120.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $120.00 / $127.50	Professional		$120.00	$120.00	$127.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $142.50	Professional		$127.50	$127.50	$142.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $66.51 / $66.51 / $81.30	Facility		$66.51	$66.51	$81.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Facility		$127.50	$127.50	$127.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Professional		$127.50	$127.50	$127.50
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Facility		$127.50	$127.50	$127.50
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $150.00	Professional		$127.50	$127.50	$150.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $50.00 / $60.00	Professional		$40.00	$50.00	$60.00
United Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $150.00 / $150.00	Facility		$150.00	$150.00	$150.00
United Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $150.00 / $186.15	Professional		$150.00	$150.00	$186.15