Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $51.29 / $199.53	Facility		$24.55	$51.29	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $23.44 / $60.26	Professional		$18.20	$23.44	$60.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $27.54 / $47.86	Facility		$23.44	$27.54	$47.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $15.85 / $33.11	Professional		$12.88	$15.85	$33.11
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $20.42 / $20.42	Professional		$20.42	$20.42	$20.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $20.89 / $29.51	Facility		$20.89	$20.89	$29.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $25.70 / $34.67	Professional		$16.60	$25.70	$34.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.60 / $16.98 / $74.13	Facility		$16.60	$16.98	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $16.60 / $37.15	Professional		$13.18	$16.60	$37.15
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $54.95 / $158.49	Facility		$16.98	$54.95	$158.49
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $20.89 / $45.71	Professional		$13.18	$20.89	$45.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $21.38 / $31.62	Professional		$17.38	$21.38	$31.62
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $30.90 / $30.90	Facility		$30.90	$30.90	$30.90
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $26.92 / $51.29	Professional		$16.60	$26.92	$51.29
United Facility/Professional Facility Modifier Low / Median / High Price $9.33 / $17.78 / $25.70	Facility		$9.33	$17.78	$25.70
United Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $15.49 / $30.90	Professional		$10.96	$15.49	$30.90