Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $54.95 / $89.13	Facility		$50.12	$54.95	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $44.67 / $64.57	Professional		$28.84	$44.67	$64.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $102.33 / $204.17	Facility		$95.50	$102.33	$204.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $53.70 / $123.03	Professional		$42.66	$53.70	$123.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $72.44 / $114.82	Facility		$47.86	$72.44	$114.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $85.11 / $128.82	Professional		$61.66	$85.11	$128.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Facility		$52.48	$52.48	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $52.48	Professional		$38.90	$38.90	$52.48
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $52.48 / $128.82	Facility		$52.48	$52.48	$128.82
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $47.86	Professional		$38.90	$38.90	$47.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $57.54 / $83.18	Professional		$40.74	$57.54	$83.18
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $107.15 / $199.53	Professional		$95.50	$107.15	$199.53
United Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $38.90 / $83.18	Facility		$29.51	$38.90	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $42.66 / $60.26	Professional		$26.92	$42.66	$60.26