Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.59 / $175.86 / $204.77	Professional		$85.59	$175.86	$204.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.39 / $108.69 / $303.70	Professional		$92.39	$108.69	$303.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $253.09 / $303.70 / $379.64	Facility		$253.09	$303.70	$379.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $256.26 / $329.02 / $607.41	Professional		$256.26	$329.02	$607.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.11 / $91.11 / $91.11	Professional		$91.11	$91.11	$91.11
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $91.11 / $91.11 / $91.11	Professional		$91.11	$91.11	$91.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.59 / $140.38 / $169.63	Professional		$93.59	$140.38	$169.63
United Facility/Professional Professional Modifier Low / Median / High Price $63.13 / $114.13 / $153.97	Professional		$63.13	$114.13	$153.97