Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Facility		$67.61	$67.61	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $85.11 / $109.65	Professional		$63.10	$85.11	$109.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $138.04 / $194.98	Facility		$128.82	$138.04	$194.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $128.82 / $218.78	Professional		$97.72	$128.82	$218.78
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $169.82 / $181.97	Professional		$158.49	$169.82	$181.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.12 / $72.44 / $134.90	Facility		$9.12	$72.44	$134.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $87.10 / $134.90	Professional		$11.48	$87.10	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $114.82	Facility		$81.28	$81.28	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $141.25	Professional		$69.18	$69.18	$141.25
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $141.25	Facility		$81.28	$81.28	$141.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $81.28 / $107.15	Professional		$64.57	$81.28	$107.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $151.36 / $223.87	Professional		$91.20	$151.36	$223.87
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $162.18 / $269.15	Professional		$138.04	$162.18	$269.15
United Facility/Professional Facility Modifier Low / Median / High Price $8.13 / $66.07 / $102.33	Facility		$8.13	$66.07	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $79.43 / $128.82	Professional		$45.71	$79.43	$128.82