Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.02 / $26.30 / $54.95	Facility		$12.02	$26.30	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $12.88 / $30.90	Professional		$9.55	$12.88	$30.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $13.49 / $15.49 / $26.92	Facility		$13.49	$15.49	$26.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $8.91 / $19.05	Professional		$7.24	$8.91	$19.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.00 / $10.00 / $16.98	Facility		$10.00	$10.00	$16.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Professional		$19.95	$19.95	$19.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $9.55 / $9.55 / $60.26	Facility		$9.55	$9.55	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $7.41 / $9.55 / $27.54	Professional		$7.41	$9.55	$27.54
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $9.55 / $15.49 / $60.26	Facility		$9.55	$15.49	$60.26
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $7.41 / $9.55 / $20.42	Professional		$7.41	$9.55	$20.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $12.02 / $18.20	Professional		$10.00	$12.02	$18.20
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $17.78 / $17.78	Facility		$17.78	$17.78	$17.78
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $15.49 / $33.88	Professional		$9.55	$15.49	$33.88
United Facility/Professional Facility Modifier Low / Median / High Price $5.25 / $10.00 / $14.79	Facility		$5.25	$10.00	$14.79
United Facility/Professional Professional Modifier Low / Median / High Price $6.17 / $8.91 / $19.05	Professional		$6.17	$8.91	$19.05