Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $50.12 / $74.13	Facility		$23.99	$50.12	$74.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $26.92 / $60.26	Professional		$21.88	$26.92	$60.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $31.62 / $54.95	Facility		$27.54	$31.62	$54.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $18.62 / $38.90	Professional		$14.79	$18.62	$38.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $23.99 / $33.88	Facility		$23.99	$23.99	$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 $19.50 / $19.50 / $120.23	Facility		$19.50	$19.50	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $19.05 / $42.66	Professional		$15.14	$19.05	$42.66
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $30.90 / $123.03	Facility		$19.50	$30.90	$123.03
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $19.05 / $41.69	Professional		$15.14	$19.05	$41.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $26.92 / $36.31	Professional		$19.95	$26.92	$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 $19.50 / $30.90 / $69.18	Professional		$19.50	$30.90	$69.18
United Facility/Professional Facility Modifier Low / Median / High Price $10.72 / $20.42 / $29.51	Facility		$10.72	$20.42	$29.51
United Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $17.78 / $35.48	Professional		$12.59	$17.78	$35.48