Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $138.04 / $208.93	Facility		$74.13	$138.04	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $74.13 / $97.72	Professional		$72.44	$74.13	$97.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $138.04 / $478.63	Facility		$79.43	$138.04	$478.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $83.18 / $125.89	Professional		$74.13	$83.18	$125.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Facility		$74.13	$74.13	$74.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $100.00	Professional		$74.13	$74.13	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $107.15	Facility		$69.18	$69.18	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $93.33	Professional		$74.13	$74.13	$93.33
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $74.13 / $97.72	Facility		$69.18	$74.13	$97.72
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $104.71	Professional		$74.13	$74.13	$104.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $81.28 / $107.15	Professional		$74.13	$81.28	$107.15
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $83.18 / $141.25	Professional		$70.79	$83.18	$141.25
United Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Facility		$74.13	$74.13	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $74.13 / $83.18	Professional		$70.79	$74.13	$83.18