Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $43.65 / $53.70	Facility		$30.20	$43.65	$53.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $28.84 / $45.71	Professional		$21.88	$28.84	$45.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $61.66 / $123.03	Facility		$57.54	$61.66	$123.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $33.88 / $75.86	Professional		$27.54	$33.88	$75.86
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $47.86	Professional		$47.86	$47.86	$47.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $42.66 / $69.18	Facility		$28.18	$42.66	$69.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $51.29 / $77.62	Professional		$37.15	$51.29	$77.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $31.62 / $31.62	Facility		$31.62	$31.62	$31.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $22.91 / $31.62	Professional		$22.91	$22.91	$31.62
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $31.62 / $77.62	Facility		$31.62	$31.62	$77.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $22.91 / $31.62	Professional		$22.91	$22.91	$31.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $14.79 / $20.89	Professional		$10.47	$14.79	$20.89
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Facility		$69.18	$69.18	$69.18
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $64.57 / $120.23	Professional		$57.54	$64.57	$120.23
United Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $27.54 / $58.88	Facility		$19.50	$27.54	$58.88
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $26.92 / $38.90	Professional		$19.05	$26.92	$38.90