Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $93.33 / $151.36	Facility		$54.95	$93.33	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $54.95 / $70.79	Professional		$53.70	$54.95	$70.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $102.33 / $354.81	Facility		$58.88	$102.33	$354.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $61.66 / $102.33	Professional		$54.95	$61.66	$102.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Professional		$74.13	$74.13	$74.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $51.29 / $54.95	Facility		$51.29	$51.29	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $95.50	Professional		$54.95	$54.95	$95.50
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $51.29 / $54.95	Facility		$51.29	$51.29	$54.95
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $95.50	Professional		$54.95	$54.95	$95.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $67.61 / $79.43	Professional		$54.95	$67.61	$79.43
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $93.33 / $128.82	Professional		$54.95	$93.33	$128.82
United Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $61.66	Professional		$54.95	$54.95	$61.66