Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $104.71 / $245.47	Facility		$74.13	$104.71	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $91.20 / $154.88	Professional		$63.10	$91.20	$154.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,137.96 / $3,981.07	Facility		$707.95	$2,137.96	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $75.86 / $120.23	Professional		$57.54	$75.86	$120.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $66.07 / $77.62	Facility		$66.07	$66.07	$77.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $109.65 / $177.83	Professional		$74.13	$109.65	$177.83
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $109.65 / $177.83	Professional		$70.79	$109.65	$177.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $346.74	Facility		$100.00	$100.00	$346.74
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $109.65 / $165.96	Professional		$61.66	$109.65	$165.96
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $912.01 / $2,951.21	Facility		$316.23	$912.01	$2,951.21
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $91.20 / $154.88	Professional		$58.88	$91.20	$154.88