Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Facility		$72.44	$72.44	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $83.18 / $104.71	Professional		$61.66	$83.18	$104.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $147.91 / $208.93	Facility		$138.04	$147.91	$208.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $107.15 / $229.09	Professional		$93.33	$107.15	$229.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.59 / $69.18 / $128.82	Facility		$7.59	$69.18	$128.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $83.18 / $125.89	Professional		$10.00	$83.18	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $44.67 / $131.83	Facility		$44.67	$44.67	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $38.02 / $131.83	Professional		$38.02	$38.02	$131.83
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $44.67 / $131.83	Facility		$44.67	$44.67	$131.83
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $44.67 / $112.20	Professional		$38.02	$44.67	$112.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $109.65 / $173.78	Professional		$87.10	$109.65	$173.78
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $151.36 / $251.19	Professional		$128.82	$151.36	$251.19
United Facility/Professional Facility Modifier Low / Median / High Price $6.31 / $51.29 / $93.33	Facility		$6.31	$51.29	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $69.18 / $97.72	Professional		$44.67	$69.18	$97.72