Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $54.95 / $154.88	Facility		$25.70	$54.95	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.70 / $34.67	Professional		$25.12	$25.70	$34.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $54.95 / $165.96	Facility		$27.54	$54.95	$165.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $28.84 / $46.77	Professional		$25.70	$28.84	$46.77
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $32.36 / $32.36	Facility		$32.36	$32.36	$32.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Facility		$19.95	$19.95	$19.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $26.92 / $26.92	Professional		$26.92	$26.92	$26.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $23.99 / $25.70	Facility		$23.99	$23.99	$25.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $25.70 / $64.57	Professional		$25.70	$25.70	$64.57
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $23.99 / $56.23	Facility		$23.99	$23.99	$56.23
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $25.70 / $64.57	Professional		$25.70	$25.70	$64.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $27.54 / $35.48	Professional		$19.95	$27.54	$35.48
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $40.74 / $56.23	Professional		$24.55	$40.74	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $25.70 / $30.90	Professional		$25.70	$25.70	$30.90