Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $109.65 / $154.88	Facility		$60.26	$109.65	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $52.48 / $79.43	Professional		$43.65	$52.48	$79.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.92 / $8.13 / $64.57	Professional		$6.92	$8.13	$64.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Facility		$74.13	$74.13	$74.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $1,000.00 / $1,778.28	Professional		$79.43	$1,000.00	$1,778.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $41.69 / $134.90	Facility		$41.69	$41.69	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $74.13 / $91.20	Professional		$41.69	$74.13	$91.20
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $66.07 / $134.90	Facility		$41.69	$66.07	$134.90
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $41.69 / $41.69	Professional		$41.69	$41.69	$41.69
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Facility		$77.62	$77.62	$77.62
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $67.61 / $128.82	Professional		$41.69	$67.61	$128.82
United Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $41.69 / $64.57	Facility		$22.91	$41.69	$64.57
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $38.90 / $64.57	Professional		$26.92	$38.90	$64.57