Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $117.49 / $177.83	Facility		$64.57	$117.49	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $64.57 / $120.23	Professional		$63.10	$64.57	$120.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $102.33 / $229.09	Facility		$69.18	$102.33	$229.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $70.79 / $114.82	Professional		$64.57	$70.79	$114.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Facility		$63.10	$63.10	$63.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $64.57	Facility		$60.26	$60.26	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $169.82	Professional		$64.57	$64.57	$169.82
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $64.57	Facility		$60.26	$60.26	$64.57
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $169.82	Professional		$64.57	$64.57	$169.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $79.43 / $93.33	Professional		$63.10	$79.43	$93.33
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $109.65 / $151.36	Professional		$64.57	$109.65	$151.36
United Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $64.57 / $64.57	Facility		$63.10	$64.57	$64.57
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $64.57 / $75.86	Professional		$57.54	$64.57	$75.86