Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $25.70 / $44.67	Facility		$13.18	$25.70	$44.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $12.88 / $30.20	Professional		$12.88	$12.88	$30.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $28.18 / $85.11	Facility		$14.13	$28.18	$85.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $14.79 / $26.30	Professional		$13.18	$14.79	$26.30
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $12.02 / $12.02 / $12.02	Facility		$12.02	$12.02	$12.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $28.84 / $28.84	Facility		$28.84	$28.84	$28.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $38.90	Professional		$38.90	$38.90	$38.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $12.30 / $13.18	Facility		$12.30	$12.30	$13.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $13.18 / $128.82	Professional		$13.18	$13.18	$128.82
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $12.30 / $13.18	Facility		$12.30	$12.30	$13.18
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $13.18 / $138.04	Professional		$13.18	$13.18	$138.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $19.05 / $39.81	Professional		$13.18	$19.05	$39.81
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $15.14 / $20.89	Professional		$9.12	$15.14	$20.89
United Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $13.18 / $19.05	Professional		$13.18	$13.18	$19.05