Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $64.57 / $208.93	Facility		$23.44	$64.57	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $22.91 / $50.12	Professional		$22.91	$22.91	$50.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $48.98 / $151.36	Facility		$25.12	$48.98	$151.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $26.30 / $40.74	Professional		$22.91	$26.30	$40.74
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $38.90	Facility		$38.90	$38.90	$38.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $21.38 / $21.38	Facility		$21.38	$21.38	$21.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $21.38 / $28.84	Professional		$21.38	$21.38	$28.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $21.88 / $85.11	Facility		$21.88	$21.88	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $22.91 / $39.81	Professional		$22.91	$22.91	$39.81
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $31.62 / $104.71	Facility		$21.88	$31.62	$104.71
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $22.91 / $46.77	Professional		$22.91	$22.91	$46.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $25.12 / $32.36	Professional		$21.38	$25.12	$32.36
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $23.99 / $31.62	Professional		$17.38	$23.99	$31.62
United Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $22.91 / $79.43	Professional		$21.38	$22.91	$79.43