Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $114.82 / $213.80	Facility		$47.86	$114.82	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $53.70 / $117.49	Professional		$42.66	$53.70	$117.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $61.66 / $107.15	Facility		$53.70	$61.66	$107.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $36.31 / $75.86	Professional		$28.84	$36.31	$75.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $46.77 / $66.07	Facility		$46.77	$46.77	$66.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Professional		$77.62	$77.62	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $83.18 / $144.54	Professional		$66.07	$83.18	$144.54
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Professional		$97.72	$97.72	$97.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $52.48 / $72.44	Professional		$38.90	$52.48	$72.44
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Facility		$69.18	$69.18	$69.18
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $60.26 / $134.90	Professional		$38.02	$60.26	$134.90
United Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $39.81 / $57.54	Facility		$20.89	$39.81	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $34.67 / $69.18	Professional		$24.55	$34.67	$69.18