Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.98 / $87.98 / $197.00	Facility		$87.98	$87.98	$197.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $90.62	Professional		$87.98	$87.98	$90.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $101.17 / $171.30	Professional		$87.98	$101.17	$171.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $87.98 / $87.98 / $132.85	Facility		$87.98	$87.98	$132.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $118.77	Professional		$87.98	$87.98	$118.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.00 / $83.00 / $87.98	Facility		$83.00	$83.00	$87.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $87.98	Professional		$87.98	$87.98	$87.98
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $149.77 / $149.77 / $149.77	Facility		$149.77	$149.77	$149.77
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $103.75	Professional		$87.98	$87.98	$103.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $88.52 / $104.42 / $156.63	Professional		$88.52	$104.42	$156.63
United Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $109.18	Professional		$87.98	$87.98	$109.18