Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $16.22 / $25.70 / $41.69	Facility		$16.22	$25.70	$41.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $14.13 / $19.95	Professional		$12.02	$14.13	$19.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.62 / $7.08 / $19.50	Professional		$5.62	$7.08	$19.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $15.49 / $17.38 / $19.95	Facility		$15.49	$17.38	$19.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $269.15 / $478.63	Professional		$20.89	$269.15	$478.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $11.22 / $11.22 / $36.31	Facility		$11.22	$11.22	$36.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $19.95 / $24.55	Professional		$11.22	$19.95	$24.55
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $11.22 / $17.78 / $36.31	Facility		$11.22	$17.78	$36.31
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $11.22 / $11.22	Professional		$11.22	$11.22	$11.22
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 $20.89 / $20.89 / $20.89	Facility		$20.89	$20.89	$20.89
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $18.20 / $34.67	Professional		$11.22	$18.20	$34.67
United Facility/Professional Facility Modifier Low / Median / High Price $6.17 / $11.22 / $17.38	Facility		$6.17	$11.22	$17.38
United Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $10.47 / $17.38	Professional		$7.24	$10.47	$17.38