Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.56 / $102.85 / $410.99	Facility		$47.56	$102.85	$410.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $40.65 / $51.63	Professional		$40.65	$40.65	$51.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.98 / $95.12 / $264.23	Facility		$60.98	$95.12	$264.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $44.71 / $75.20	Professional		$40.65	$44.71	$75.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $40.65 / $40.65 / $61.38	Facility		$40.65	$40.65	$61.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $40.65 / $54.88	Professional		$40.65	$40.65	$54.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.35 / $38.35 / $40.65	Facility		$38.35	$38.35	$40.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $40.65 / $56.16	Professional		$40.65	$40.65	$56.16
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $19.03 / $37.51 / $88.79	Facility		$19.03	$37.51	$88.79
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $40.65 / $57.53	Professional		$40.65	$40.65	$57.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.20 / $49.44 / $58.94	Professional		$41.20	$49.44	$58.94
United Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $40.65 / $56.16	Professional		$40.65	$40.65	$56.16