Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $25.70 / $41.69	Facility		$15.14	$25.70	$41.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $15.14 / $19.50	Professional		$15.14	$15.14	$19.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $16.22 / $28.18 / $77.62	Facility		$16.22	$28.18	$77.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $16.60 / $27.54	Professional		$15.14	$16.60	$27.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $15.14 / $15.14	Facility		$15.14	$15.14	$15.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $20.42 / $20.42	Professional		$20.42	$20.42	$20.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $14.13 / $15.14	Facility		$14.13	$14.13	$15.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $15.14 / $23.99	Professional		$15.14	$15.14	$23.99
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $14.13 / $15.14	Facility		$14.13	$14.13	$15.14
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $15.14 / $23.99	Professional		$15.14	$15.14	$23.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $18.62 / $21.88	Professional		$15.14	$18.62	$21.88
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $25.12 / $34.67	Professional		$15.14	$25.12	$34.67
United Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $15.14 / $15.14	Facility		$15.14	$15.14	$15.14
United Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $15.14 / $16.22	Professional		$15.14	$15.14	$16.22