Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $44.67 / $95.50	Facility		$21.38	$44.67	$95.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $21.38 / $27.54	Professional		$20.89	$21.38	$27.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $45.71 / $138.04	Facility		$22.91	$45.71	$138.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $23.44 / $37.15	Professional		$21.38	$23.44	$37.15
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $28.84 / $28.84	Facility		$28.84	$28.84	$28.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $20.89 / $20.89	Facility		$20.89	$20.89	$20.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $28.18 / $28.18	Professional		$28.18	$28.18	$28.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $21.38	Facility		$19.95	$19.95	$21.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $21.38 / $31.62	Professional		$21.38	$21.38	$31.62
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $21.38 / $79.43	Facility		$19.95	$21.38	$79.43
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $21.38 / $31.62	Professional		$21.38	$21.38	$31.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $25.70 / $30.20	Professional		$20.89	$25.70	$30.20
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $36.31 / $50.12	Professional		$21.38	$36.31	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $21.38 / $22.91	Professional		$21.38	$21.38	$22.91