Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.45 / $85.61 / $125.58	Facility		$39.45	$85.61	$125.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.45 / $40.63 / $112.26	Professional		$39.45	$40.63	$112.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $59.18 / $92.31 / $256.43	Facility		$59.18	$92.31	$256.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.45 / $39.45 / $74.95	Professional		$39.45	$39.45	$74.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.45 / $39.45 / $67.06	Facility		$39.45	$39.45	$67.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.45 / $39.45 / $53.26	Professional		$39.45	$39.45	$53.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.21 / $37.21 / $39.45	Facility		$37.21	$37.21	$39.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.45 / $39.45 / $131.57	Professional		$39.45	$39.45	$131.57
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $39.45 / $39.45 / $136.83	Professional		$39.45	$39.45	$136.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.60 / $47.09 / $57.20	Professional		$40.60	$47.09	$57.20
United Facility/Professional Professional Modifier Low / Median / High Price $39.45 / $39.45 / $51.36	Professional		$39.45	$39.45	$51.36