Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $67.61 / $128.82	Facility		$36.31	$67.61	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $36.31 / $67.61	Professional		$18.20	$36.31	$67.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $46.77 / $81.28	Facility		$40.74	$46.77	$81.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $21.38 / $50.12	Professional		$17.78	$21.38	$50.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $25.70 / $50.12	Facility		$25.70	$25.70	$50.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Professional		$58.88	$58.88	$58.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $28.84 / $147.91	Facility		$28.84	$28.84	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $19.95 / $57.54	Professional		$11.48	$19.95	$57.54
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $45.71 / $147.91	Facility		$21.88	$45.71	$147.91
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $19.95 / $28.84	Professional		$11.48	$19.95	$28.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $39.81 / $54.95	Professional		$29.51	$39.81	$54.95
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Facility		$52.48	$52.48	$52.48
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $45.71 / $102.33	Professional		$28.84	$45.71	$102.33
United Facility/Professional Facility Modifier Low / Median / High Price $13.49 / $21.88 / $43.65	Facility		$13.49	$21.88	$43.65
United Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $18.62 / $43.65	Professional		$10.72	$18.62	$43.65