Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $66.07 / $107.15	Facility		$33.88	$66.07	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $36.31 / $70.79	Professional		$32.36	$36.31	$70.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $45.71 / $79.43	Facility		$38.90	$45.71	$79.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $26.92 / $57.54	Professional		$21.38	$26.92	$57.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Facility		$48.98	$48.98	$48.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Professional		$57.54	$57.54	$57.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $27.54 / $162.18	Facility		$27.54	$27.54	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $38.90 / $83.18	Professional		$21.88	$38.90	$83.18
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $43.65 / $162.18	Facility		$38.02	$43.65	$162.18
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $38.90 / $85.11	Professional		$21.88	$38.90	$85.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $38.90 / $52.48	Professional		$32.36	$38.90	$52.48
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $51.29 / $51.29	Facility		$51.29	$51.29	$51.29
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $52.48 / $100.00	Professional		$36.31	$52.48	$100.00
United Facility/Professional Facility Modifier Low / Median / High Price $15.49 / $38.90 / $42.66	Facility		$15.49	$38.90	$42.66
United Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $25.70 / $58.88	Professional		$17.78	$25.70	$58.88