Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $30.90 / $51.29	Facility		$18.20	$30.90	$51.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $18.20 / $23.99	Professional		$18.20	$18.20	$23.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $33.88 / $95.50	Facility		$19.95	$33.88	$95.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $20.42 / $33.11	Professional		$18.20	$20.42	$33.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $18.20 / $18.20	Facility		$18.20	$18.20	$18.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $24.55 / $24.55	Professional		$24.55	$24.55	$24.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $17.38 / $17.38 / $18.20	Facility		$17.38	$17.38	$18.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $18.20 / $26.92	Professional		$18.20	$18.20	$26.92
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $17.38 / $17.38 / $38.90	Facility		$17.38	$17.38	$38.90
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $18.20 / $26.92	Professional		$18.20	$18.20	$26.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $22.39 / $26.30	Professional		$18.20	$22.39	$26.30
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $30.90 / $42.66	Professional		$18.20	$30.90	$42.66
United Facility/Professional Facility Modifier Low / Median / High Price $14.79 / $18.20 / $18.20	Facility		$14.79	$18.20	$18.20
United Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $18.20 / $19.95	Professional		$18.20	$18.20	$19.95