Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $85.11 / $676.08	Facility		$37.15	$85.11	$676.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $40.74 / $123.03	Professional		$33.11	$40.74	$123.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,000.00 / $1,047.13	Facility		$891.25	$1,000.00	$1,047.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $53.70 / $87.10	Professional		$42.66	$53.70	$87.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $36.31 / $36.31	Facility		$36.31	$36.31	$36.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $398.11 / $741.31	Facility		$398.11	$398.11	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $56.23 / $95.50	Professional		$35.48	$56.23	$95.50
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,230.27 / $1,288.25	Facility		$741.31	$1,230.27	$1,288.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $57.54 / $95.50	Professional		$36.31	$57.54	$95.50
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 $489.78 / $489.78 / $489.78	Facility		$489.78	$489.78	$489.78
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $57.54 / $89.13	Professional		$41.69	$57.54	$89.13
United Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $954.99	Facility		$302.00	$302.00	$954.99
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $43.65 / $75.86	Professional		$33.11	$43.65	$75.86