Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $109.65 / $131.83	Facility		$54.95	$109.65	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $74.13 / $114.82	Professional		$54.95	$74.13	$114.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $112.20 / $229.09	Facility		$107.15	$112.20	$229.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $114.82 / $181.97	Professional		$91.20	$114.82	$181.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $91.20 / $147.91	Facility		$61.66	$91.20	$147.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $109.65 / $165.96	Professional		$79.43	$109.65	$165.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $128.82	Professional		$93.33	$93.33	$128.82
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $128.82	Professional		$93.33	$93.33	$128.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $120.23 / $173.78	Professional		$87.10	$120.23	$173.78
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $199.53 / $380.19	Professional		$162.18	$199.53	$380.19
United Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $89.13 / $165.96	Facility		$67.61	$89.13	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $91.20 / $138.04	Professional		$57.54	$91.20	$138.04