Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $45.71 / $64.57	Facility		$25.70	$45.71	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $21.88 / $33.88	Professional		$18.20	$21.88	$33.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $28.84 / $50.12	Facility		$25.12	$28.84	$50.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $45.71 / $67.61	Professional		$30.90	$45.71	$67.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $18.62 / $30.90	Facility		$18.62	$18.62	$30.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $426.58 / $758.58	Professional		$33.11	$426.58	$758.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $17.78 / $57.54	Facility		$17.78	$17.78	$57.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $31.62 / $38.90	Professional		$17.78	$31.62	$38.90
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $28.18 / $57.54	Facility		$17.78	$28.18	$57.54
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $17.78 / $17.78	Professional		$17.78	$17.78	$17.78
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $32.36 / $32.36	Facility		$32.36	$32.36	$32.36
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $28.18 / $53.70	Professional		$17.78	$28.18	$53.70
United Facility/Professional Facility Modifier Low / Median / High Price $9.77 / $17.78 / $26.92	Facility		$9.77	$17.78	$26.92
United Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $16.22 / $26.92	Professional		$11.48	$16.22	$26.92