Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $144.54 / $213.80	Facility		$67.61	$144.54	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $70.79 / $87.10	Professional		$67.61	$70.79	$87.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $0.02 / $0.02 / $0.07	Facility		$0.02	$0.02	$0.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $70.79 / $104.71	Professional		$60.26	$70.79	$104.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $26.30 / $26.30	Facility		$26.30	$26.30	$26.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Facility		$60.26	$60.26	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $112.20	Professional		$60.26	$60.26	$112.20
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Facility		$60.26	$60.26	$60.26
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $112.20	Professional		$60.26	$60.26	$112.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $75.86 / $87.10	Professional		$60.26	$75.86	$87.10
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Professional		$60.26	$60.26	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $75.86	Professional		$70.79	$70.79	$75.86