Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Facility		$52.48	$52.48	$52.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $52.48 / $61.66	Professional		$38.02	$52.48	$61.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $100.00 / $165.96	Professional		$72.44	$100.00	$165.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $794.33 / $41,686.94	Facility		$52.48	$794.33	$41,686.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $891.25 / $1,584.89	Professional		$69.18	$891.25	$1,584.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $263.03 / $263.03	Professional		$89.13	$263.03	$263.03
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $263.03 / $263.03	Professional		$89.13	$263.03	$263.03
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 $117.49 / $117.49 / $117.49	Facility		$117.49	$117.49	$117.49
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 $69.18 / $69.18 / $229.09	Facility		$69.18	$69.18	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $64.57 / $109.65	Professional		$45.71	$64.57	$109.65