Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $72.44 / $154.88	Facility		$38.02	$72.44	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $38.90 / $104.71	Professional		$32.36	$38.90	$104.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $50.12 / $87.10	Facility		$42.66	$50.12	$87.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $23.99 / $87.10	Professional		$18.62	$23.99	$87.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Facility		$53.70	$53.70	$53.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Professional		$63.10	$63.10	$63.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $30.90 / $162.18	Facility		$30.90	$30.90	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $42.66 / $100.00	Professional		$21.38	$42.66	$100.00
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $47.86 / $162.18	Facility		$41.69	$47.86	$162.18
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $25.12 / $104.71	Professional		$21.38	$25.12	$104.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $42.66 / $57.54	Professional		$35.48	$42.66	$57.54
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $56.23 / $56.23	Facility		$56.23	$56.23	$56.23
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $56.23 / $109.65	Professional		$39.81	$56.23	$109.65
United Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $42.66 / $46.77	Facility		$16.98	$42.66	$46.77
United Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $28.18 / $53.70	Professional		$19.95	$28.18	$53.70