Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $95.50 / $154.88	Facility		$60.26	$95.50	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $52.48 / $77.62	Professional		$44.67	$52.48	$77.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $12.02 / $102.33	Professional		$12.02	$12.02	$102.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $77.62	Facility		$74.13	$74.13	$77.62
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 / $93.33	Professional		$41.69	$74.13	$93.33
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
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Professional		$1,513.56	$1,513.56	$1,513.56
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 $23.44 / $41.69 / $64.57	Facility		$23.44	$41.69	$64.57
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $38.90 / $77.62	Professional		$26.92	$38.90	$77.62