Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $89.13 / $134.90	Facility		$75.86	$89.13	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $70.79 / $97.72	Professional		$51.29	$70.79	$97.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $151.36 / $309.03	Facility		$144.54	$151.36	$309.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $79.43 / $181.97	Professional		$69.18	$79.43	$181.97
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 $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $67.61 / $91.20	Professional		$67.61	$67.61	$91.20
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $154.88	Facility		$91.20	$91.20	$154.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $67.61 / $91.20	Professional		$67.61	$67.61	$91.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $87.10 / $123.03	Professional		$61.66	$87.10	$123.03
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $162.18 / $295.12	Professional		$144.54	$162.18	$295.12
United Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $61.66 / $131.83	Facility		$47.86	$61.66	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $64.57 / $91.20	Professional		$43.65	$64.57	$91.20