Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.45 / $28.84 / $43.65	Facility		$14.45	$28.84	$43.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $14.45 / $30.90	Professional		$14.13	$14.45	$30.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $15.49 / $26.92 / $74.13	Facility		$15.49	$26.92	$74.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $16.22 / $25.12	Professional		$14.45	$16.22	$25.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4.17 / $4.17 / $4.17	Facility		$4.17	$4.17	$4.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $4.17 / $4.17 / $5.62	Professional		$4.17	$4.17	$5.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $13.49 / $13.49 / $14.45	Facility		$13.49	$13.49	$14.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $14.45 / $20.42	Professional		$14.45	$14.45	$20.42
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $10.96 / $13.49 / $85.11	Facility		$10.96	$13.49	$85.11
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $14.45 / $87.10	Professional		$14.45	$14.45	$87.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $4.17 / $14.45 / $18.62	Professional		$4.17	$14.45	$18.62
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $15.14 / $25.12	Professional		$11.48	$15.14	$25.12
United Facility/Professional Facility Modifier Low / Median / High Price $4.17 / $14.45 / $14.45	Facility		$4.17	$14.45	$14.45
United Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $15.14 / $17.78	Professional		$13.80	$15.14	$17.78