Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $79.43 / $128.82	Facility		$72.44	$79.43	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $63.10 / $91.20	Professional		$45.71	$63.10	$91.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $144.54 / $295.12	Facility		$138.04	$144.54	$295.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $77.62 / $173.78	Professional		$63.10	$77.62	$173.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $87.10 / $138.04	Facility		$57.54	$87.10	$138.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $102.33 / $154.88	Professional		$74.13	$102.33	$154.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $87.10	Professional		$63.10	$63.10	$87.10
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $154.88	Facility		$87.10	$87.10	$154.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $87.10	Professional		$63.10	$63.10	$87.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $83.18 / $117.49	Professional		$58.88	$83.18	$117.49
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Facility		$165.96	$165.96	$165.96
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $154.88 / $281.84	Professional		$138.04	$154.88	$281.84
United Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $56.23 / $117.49	Facility		$41.69	$56.23	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $60.26 / $85.11	Professional		$38.02	$60.26	$85.11