Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $109.44 / $400.00	Facility		$109.44	$109.44	$400.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $112.72	Professional		$109.44	$109.44	$112.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $125.85 / $218.38	Professional		$109.44	$125.85	$218.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $109.44 / $186.05	Facility		$109.44	$109.44	$186.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $147.74	Professional		$109.44	$109.44	$147.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $103.24 / $103.24 / $109.44	Facility		$103.24	$103.24	$109.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $214.54	Professional		$109.44	$109.44	$214.54
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,417.80 / $1,417.80 / $1,417.80	Facility		$1,417.80	$1,417.80	$1,417.80
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $214.54	Professional		$109.44	$109.44	$214.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $120.38 / $180.57 / $340.69	Professional		$120.38	$180.57	$340.69
United Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $142.49	Professional		$109.44	$109.44	$142.49