Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $158.49 / $269.15	Facility		$104.71	$158.49	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $91.20 / $141.25	Professional		$77.62	$91.20	$141.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.92 / $8.13 / $112.20	Professional		$6.92	$8.13	$112.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $128.82	Facility		$112.20	$112.20	$128.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $1,737.80 / $3,090.30	Professional		$138.04	$1,737.80	$3,090.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $234.42	Facility		$72.44	$72.44	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $128.82 / $162.18	Professional		$72.44	$128.82	$162.18
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $114.82 / $234.42	Facility		$72.44	$114.82	$234.42
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Professional		$72.44	$72.44	$72.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $50.12 / $50.12	Professional		$39.81	$50.12	$50.12
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $117.49 / $223.87	Professional		$72.44	$117.49	$223.87
United Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $72.44 / $112.20	Facility		$40.74	$72.44	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $67.61 / $112.20	Professional		$46.77	$67.61	$112.20