Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $56.23 / $338.84	Facility		$26.30	$56.23	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $26.30 / $56.23	Professional		$25.70	$26.30	$56.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $48.98 / $169.82	Facility		$28.18	$48.98	$169.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $29.51 / $44.67	Professional		$26.30	$29.51	$44.67
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Facility		$67.61	$67.61	$67.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $20.42 / $20.42 / $20.42	Facility		$20.42	$20.42	$20.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $20.42 / $27.54	Professional		$20.42	$20.42	$27.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $24.55 / $72.44	Facility		$24.55	$24.55	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $26.30 / $44.67	Professional		$26.30	$26.30	$44.67
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $26.30 / $151.36	Facility		$24.55	$26.30	$151.36
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $26.30 / $70.79	Professional		$26.30	$26.30	$70.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $26.30 / $33.88	Professional		$20.42	$26.30	$33.88
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $32.36 / $54.95	Professional		$27.54	$32.36	$54.95
United Facility/Professional Facility Modifier Low / Median / High Price $20.42 / $26.30 / $26.30	Facility		$20.42	$26.30	$26.30
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $26.30 / $30.20	Professional		$24.55	$26.30	$30.20