Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4.17 / $8.71 / $50.12	Facility		$4.17	$8.71	$50.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3.98 / $3.98 / $5.62	Professional		$3.98	$3.98	$5.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4.57 / $9.12 / $27.54	Facility		$4.57	$9.12	$27.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4.17 / $4.57 / $7.41	Professional		$4.17	$4.57	$7.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4.17 / $4.17 / $4.17	Facility		$4.17	$4.17	$4.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $5.62 / $5.62 / $5.62	Professional		$5.62	$5.62	$5.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3.98 / $3.98 / $4.17	Facility		$3.98	$3.98	$4.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4.17 / $4.17 / $7.24	Professional		$4.17	$4.17	$7.24
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $3.98 / $4.17 / $5.50	Facility		$3.98	$4.17	$5.50
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $4.17 / $4.17 / $7.24	Professional		$4.17	$4.17	$7.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $4.17 / $5.25 / $6.03	Professional		$4.17	$5.25	$6.03
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $4.17 / $7.08 / $9.77	Professional		$4.17	$7.08	$9.77
United Facility/Professional Professional Modifier Low / Median / High Price $4.17 / $4.17 / $4.57	Professional		$4.17	$4.17	$4.57