Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $83.18 / $102.33	Facility		$57.54	$83.18	$102.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $54.95 / $83.18	Professional		$41.69	$54.95	$83.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $114.82 / $234.42	Facility		$109.65	$114.82	$234.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $63.10 / $141.25	Professional		$52.48	$63.10	$141.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $81.28 / $128.82	Facility		$53.70	$81.28	$128.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $97.72 / $144.54	Professional		$70.79	$97.72	$144.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Facility		$60.26	$60.26	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $60.26	Professional		$43.65	$43.65	$60.26
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Facility		$60.26	$60.26	$60.26
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $60.26	Professional		$43.65	$43.65	$60.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $44.67 / $63.10	Professional		$31.62	$44.67	$63.10
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $123.03 / $223.87	Professional		$109.65	$123.03	$223.87
United Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $51.29 / $109.65	Facility		$37.15	$51.29	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $51.29 / $72.44	Professional		$35.48	$51.29	$72.44