Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $39.81 / $64.57	Facility		$23.44	$39.81	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $22.91 / $37.15	Professional		$22.91	$22.91	$37.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $50.12 / $151.36	Facility		$25.12	$50.12	$151.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $25.70 / $40.74	Professional		$23.44	$25.70	$40.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $23.44 / $23.44	Facility		$23.44	$23.44	$23.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $31.62 / $31.62	Professional		$31.62	$31.62	$31.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $21.88 / $23.44	Facility		$21.88	$21.88	$23.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $23.44 / $57.54	Professional		$23.44	$23.44	$57.54
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $21.88 / $23.44	Facility		$21.88	$21.88	$23.44
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $23.44 / $57.54	Professional		$23.44	$23.44	$57.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $28.84 / $33.88	Professional		$23.44	$28.84	$33.88
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $38.90 / $53.70	Professional		$22.91	$38.90	$53.70
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $23.44 / $30.20	Professional		$23.44	$23.44	$30.20