Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $45.71 / $75.86	Facility		$23.99	$45.71	$75.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $23.99 / $46.77	Professional		$18.20	$23.99	$46.77
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 $12.02 / $15.14 / $38.90	Professional		$12.02	$15.14	$38.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $34.67 / $34.67	Facility		$34.67	$34.67	$34.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $40.74 / $40.74	Professional		$40.74	$40.74	$40.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $19.50 / $102.33	Facility		$19.50	$19.50	$102.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $22.39 / $53.70	Professional		$12.88	$22.39	$53.70
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $30.90 / $102.33	Facility		$22.39	$30.90	$102.33
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $19.95 / $53.70	Professional		$12.88	$19.95	$53.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $26.92 / $37.15	Professional		$22.39	$26.92	$37.15
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $36.31 / $36.31	Facility		$36.31	$36.31	$36.31
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $37.15 / $69.18	Professional		$25.70	$37.15	$69.18
United Facility/Professional Facility Modifier Low / Median / High Price $10.72 / $26.92 / $30.20	Facility		$10.72	$26.92	$30.20
United Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $18.20 / $34.67	Professional		$12.02	$18.20	$34.67