Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.13 / $69.92 / $168.07	Facility		$41.13	$69.92	$168.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.56 / $43.85 / $96.75	Professional		$33.56	$43.85	$96.75
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $71.68 / $71.68 / $74.55	Professional	CQ	$71.68	$71.68	$74.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $37.00 / $41.00 / $76.19	Facility		$37.00	$41.00	$76.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.35 / $53.48 / $91.62	Professional		$38.35	$53.48	$91.62
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $83.11 / $83.11 / $83.11	Facility		$83.11	$83.11	$83.11
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $45.10 / $51.54 / $51.54	Professional		$45.10	$51.54	$51.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $64.43 / $70.87 / $95.70	Facility		$64.43	$70.87	$95.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $64.43 / $77.36 / $145.72	Professional		$64.43	$77.36	$145.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $65.00 / $140.00	Facility		$65.00	$65.00	$140.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.42 / $56.49 / $97.15	Professional		$41.42	$56.49	$97.15
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $57.98 / $117.87 / $267.83	Facility		$57.98	$117.87	$267.83
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $46.07 / $77.31 / $112.50	Professional		$46.07	$77.31	$112.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.54 / $68.38 / $97.35	Professional		$52.54	$68.38	$97.35
United Facility/Professional Professional Modifier Low / Median / High Price $40.93 / $51.83 / $74.34	Professional		$40.93	$51.83	$74.34