Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $97.72 / $169.82	Facility		$61.66	$97.72	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $63.10 / $91.20	Professional		$52.48	$63.10	$91.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $42.66 / $66.07	Professional		$37.15	$42.66	$66.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1.62 / $5.37 / $158.49	Facility		$1.62	$5.37	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $44.67 / $158.49	Professional		$28.18	$44.67	$158.49
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $3.16 / $91.20 / $316.23	Facility		$3.16	$91.20	$316.23
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $42.66 / $177.83	Professional		$28.18	$42.66	$177.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $53.70 / $69.18	Professional		$35.48	$53.70	$69.18
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Facility		$208.93	$208.93	$208.93
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $60.26 / $75.86	Professional		$50.12	$60.26	$75.86
United Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $338.84 / $489.78	Facility		$128.82	$338.84	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $38.02 / $57.54	Professional		$24.55	$38.02	$57.54