Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $67.61 / $67.61	Facility		$63.10	$67.61	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $61.66 / $70.79	Professional		$47.86	$61.66	$70.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $117.49 / $190.55	Professional		$89.13	$117.49	$190.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $1,000.00 / $41,686.94	Facility		$66.07	$1,000.00	$41,686.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $1,122.02 / $1,995.26	Professional		$89.13	$1,122.02	$1,995.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $331.13 / $331.13	Professional		$112.20	$331.13	$331.13
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $331.13 / $331.13	Professional		$112.20	$331.13	$331.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $50.12 / $60.26	Professional		$39.81	$50.12	$60.26
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Facility		$158.49	$158.49	$158.49
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $60.26 / $75.86	Professional		$50.12	$60.26	$75.86
United Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $309.03	Facility		$117.49	$117.49	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $75.86 / $120.23	Professional		$54.95	$75.86	$120.23