Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $60.26 / $83.18	Facility		$46.77	$60.26	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $54.95 / $81.28	Professional		$38.90	$54.95	$81.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $95.50 / $141.25	Facility		$91.20	$95.50	$141.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $75.86 / $125.89	Professional		$53.70	$75.86	$125.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $91.20 / $117.49	Facility		$44.67	$91.20	$117.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $112.20 / $123.03	Professional		$58.88	$112.20	$123.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $144.54	Facility		$64.57	$64.57	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $69.18	Professional		$54.95	$54.95	$69.18
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $123.03	Facility		$64.57	$64.57	$123.03
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $64.57	Professional		$54.95	$54.95	$64.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $69.18 / $100.00	Professional		$56.23	$69.18	$100.00
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $123.03 / $257.04	Professional		$109.65	$123.03	$257.04
United Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $54.95 / $70.79	Facility		$41.69	$54.95	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $47.86 / $79.43	Professional		$30.20	$47.86	$79.43