Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Facility		$53.70	$53.70	$53.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $67.61 / $104.71	Professional		$34.67	$67.61	$104.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $251.19 / $407.38	Professional		$213.80	$251.19	$407.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $870.96 / $41,686.94	Facility		$42.66	$870.96	$41,686.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $977.24 / $1,737.80	Professional		$75.86	$977.24	$1,737.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Facility		$95.50	$95.50	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $27.54 / $269.15	Professional		$21.88	$27.54	$269.15
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Facility		$95.50	$95.50	$95.50
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $269.15 / $269.15	Professional		$70.79	$269.15	$269.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $53.70 / $69.18	Professional		$45.71	$53.70	$69.18
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 Professional Modifier Low / Median / High Price $67.61 / $102.33 / $177.83	Professional		$67.61	$102.33	$177.83