Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $10.71 / $29.99 / $162.00	Facility		$10.71	$29.99	$162.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.71 / $12.53 / $17.88	Professional		$10.71	$12.53	$17.88
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $12.70 / $12.70 / $12.70	Professional	CQ	$12.70	$12.70	$12.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $16.00 / $18.00 / $24.80	Facility		$16.00	$18.00	$24.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.42 / $12.84 / $22.95	Professional		$10.42	$12.84	$22.95
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $13.43 / $13.43	Professional		$11.75	$13.43	$13.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.69 / $18.47 / $24.95	Facility		$16.69	$18.47	$24.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.79 / $20.14 / $38.25	Professional		$16.79	$20.14	$38.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.96 / $65.00 / $140.00	Facility		$22.96	$65.00	$140.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.49 / $25.70 / $106.98	Professional		$14.49	$25.70	$106.98
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $32.76 / $74.11 / $161.50	Facility		$32.76	$74.11	$161.50
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $14.49 / $22.59 / $33.45	Professional		$14.49	$22.59	$33.45
Medical Mutual of Ohio Facility/Professional Professional Modifier CQ Low / Median / High Price $18.37 / $18.37 / $18.37	Professional	CQ	$18.37	$18.37	$18.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $13.80 / $20.70	Professional		$13.80	$13.80	$20.70
United Facility/Professional Professional Modifier Low / Median / High Price $12.90 / $15.95 / $23.39	Professional		$12.90	$15.95	$23.39