Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $123.03 / $173.78	Professional		$97.72	$123.03	$173.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $204.17 / $281.84	Facility		$190.55	$204.17	$281.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $162.18 / $316.23	Professional		$112.20	$162.18	$316.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.22 / $107.15 / $162.18	Facility		$16.22	$107.15	$162.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $128.82 / $194.98	Professional		$14.13	$128.82	$194.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $134.90 / $134.90	Facility		$117.49	$134.90	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $257.04	Professional		$114.82	$114.82	$257.04
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $134.90 / $218.78	Facility		$117.49	$134.90	$218.78
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $134.90 / $162.18	Professional		$114.82	$134.90	$162.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $131.83 / $213.80	Professional		$107.15	$131.83	$213.80
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $190.55 / $316.23	Professional		$162.18	$190.55	$316.23
United Facility/Professional Facility Modifier Low / Median / High Price $8.91 / $74.13 / $138.04	Facility		$8.91	$74.13	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $91.20 / $134.90	Professional		$61.66	$91.20	$134.90