Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $54.95 / $83.18	Facility		$26.92	$54.95	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $26.92 / $70.79	Professional		$20.89	$26.92	$70.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $30.90 / $53.70	Facility		$26.92	$30.90	$53.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $17.78 / $38.02	Professional		$14.45	$17.78	$38.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $33.88	Facility		$19.95	$19.95	$33.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $19.05 / $97.72	Facility		$19.05	$19.05	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $19.05 / $42.66	Professional		$14.79	$19.05	$42.66
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $30.90 / $97.72	Facility		$19.05	$30.90	$97.72
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $23.44 / $40.74	Professional		$14.79	$23.44	$40.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $26.30 / $36.31	Professional		$19.95	$26.30	$36.31
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $35.48 / $35.48	Facility		$35.48	$35.48	$35.48
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $30.90 / $67.61	Professional		$19.05	$30.90	$67.61
United Facility/Professional Facility Modifier Low / Median / High Price $10.47 / $19.95 / $29.51	Facility		$10.47	$19.95	$29.51
United Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $17.38 / $35.48	Professional		$12.30	$17.38	$35.48