Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $85.11 / $147.91	Facility		$46.77	$85.11	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $46.77 / $104.71	Professional		$29.51	$46.77	$104.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $61.66 / $107.15	Facility		$53.70	$61.66	$107.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $30.20 / $79.43	Professional		$23.44	$30.20	$79.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Facility		$67.61	$67.61	$67.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Professional		$79.43	$79.43	$79.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $38.02 / $199.53	Facility		$38.02	$38.02	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $52.48 / $117.49	Professional		$26.92	$52.48	$117.49
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $60.26 / $199.53	Facility		$50.12	$60.26	$199.53
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $31.62 / $131.83	Professional		$26.92	$31.62	$131.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $52.48 / $72.44	Professional		$43.65	$52.48	$72.44
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $70.79 / $70.79	Facility		$70.79	$70.79	$70.79
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $64.57 / $134.90	Professional		$50.12	$64.57	$134.90
United Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $52.48 / $58.88	Facility		$20.89	$52.48	$58.88
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $35.48 / $67.61	Professional		$24.55	$35.48	$67.61