Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $53.70 / $87.10	Professional		$42.66	$53.70	$87.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $31.62 / $51.29	Professional		$26.92	$31.62	$51.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $56.23 / $87.10	Professional		$43.65	$56.23	$87.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $48.98	Professional		$43.65	$43.65	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $63.10 / $112.20	Professional		$43.65	$63.10	$112.20
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $58.88 / $100.00	Professional		$40.74	$58.88	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $39.81	Professional		$32.36	$33.11	$39.81
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $57.54 / $109.65	Professional		$48.98	$57.54	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $57.54 / $91.20	Professional		$43.65	$57.54	$91.20