Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.83 / $86.43 / $135.41	Facility		$39.83	$86.43	$135.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.83 / $41.02 / $95.59	Professional		$39.83	$41.02	$95.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.01 / $69.55 / $118.69	Facility		$43.01	$69.55	$118.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.83 / $39.83 / $67.15	Professional		$39.83	$39.83	$67.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.83 / $39.83 / $67.70	Facility		$39.83	$39.83	$67.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.83 / $39.83 / $53.77	Professional		$39.83	$39.83	$53.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.57 / $37.57 / $39.83	Facility		$37.57	$37.57	$39.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.83 / $39.83 / $60.98	Professional		$39.83	$39.83	$60.98
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $39.83 / $39.83 / $60.98	Professional		$39.83	$39.83	$60.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $43.81 / $49.83 / $57.81	Professional		$43.81	$49.83	$57.81
United Facility/Professional Professional Modifier Low / Median / High Price $39.83 / $39.83 / $43.08	Professional		$39.83	$39.83	$43.08