Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $25.70 / $39.81	Facility		$14.13	$25.70	$39.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $14.13 / $18.62	Professional		$14.13	$14.13	$18.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $15.49 / $26.30 / $93.33	Facility		$15.49	$26.30	$93.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $16.22 / $24.55	Professional		$14.13	$16.22	$24.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $14.45 / $14.45 / $14.45	Facility		$14.45	$14.45	$14.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $14.45 / $19.50	Professional		$14.45	$14.45	$19.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $13.49 / $13.49 / $20.89	Facility		$13.49	$13.49	$20.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $14.13 / $18.20	Professional		$14.13	$14.13	$18.20
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $13.49 / $14.13 / $19.05	Facility		$13.49	$14.13	$19.05
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $14.13 / $19.95	Professional		$14.13	$14.13	$19.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $15.85 / $20.89	Professional		$14.13	$15.85	$20.89
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $17.38 / $26.92	Professional		$14.13	$17.38	$26.92
United Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $14.13 / $14.45	Facility		$14.13	$14.13	$14.45
United Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $14.13 / $15.85	Professional		$13.49	$14.13	$15.85