Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $128.82 / $208.93	Facility		$75.86	$128.82	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $97.72	Professional		$75.86	$75.86	$97.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $128.82 / $269.15	Facility		$81.28	$128.82	$269.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $83.18 / $131.83	Professional		$75.86	$83.18	$131.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Facility		$75.86	$75.86	$75.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Professional		$102.33	$102.33	$102.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $70.79 / $75.86	Facility		$70.79	$70.79	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $123.03	Professional		$75.86	$75.86	$123.03
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $70.79 / $75.86	Facility		$70.79	$70.79	$75.86
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $123.03	Professional		$75.86	$75.86	$123.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $95.50 / $109.65	Professional		$75.86	$95.50	$109.65
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $128.82 / $177.83	Professional		$75.86	$128.82	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Facility		$75.86	$75.86	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $75.86 / $81.28	Professional		$74.13	$75.86	$81.28