Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.42 / $38.02 / $56.23	Facility		$20.42	$38.02	$56.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $20.42 / $34.67	Professional		$19.95	$20.42	$34.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $38.02 / $104.71	Facility		$21.88	$38.02	$104.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $22.91 / $36.31	Professional		$20.42	$22.91	$36.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $26.92 / $26.92	Facility		$26.92	$26.92	$26.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $26.92 / $36.31	Professional		$26.92	$26.92	$36.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $19.05 / $45.71	Facility		$19.05	$19.05	$45.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $20.42 / $37.15	Professional		$20.42	$20.42	$37.15
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $20.42 / $85.11	Facility		$19.05	$20.42	$85.11
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $20.42 / $52.48	Professional		$20.42	$20.42	$52.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $26.92 / $34.67	Professional		$20.42	$26.92	$34.67
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $37.15 / $69.18	Professional		$21.38	$37.15	$69.18
United Facility/Professional Facility Modifier Low / Median / High Price $20.42 / $20.42 / $26.92	Facility		$20.42	$20.42	$26.92
United Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $21.38 / $30.90	Professional		$20.42	$21.38	$30.90