Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $10.00 / $15.85 / $23.44	Facility		$10.00	$15.85	$23.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $12.02 / $19.95	Professional		$10.00	$12.02	$19.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $27.54 / $54.95	Professional		$21.38	$27.54	$54.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $97.72 / $169.82	Facility		$22.91	$97.72	$169.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $117.49	Professional		$83.18	$83.18	$117.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $28.18 / $28.18	Facility		$28.18	$28.18	$28.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $20.42 / $28.18	Professional		$20.42	$20.42	$28.18
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $28.18 / $28.18	Facility		$28.18	$28.18	$28.18
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $20.42 / $28.18	Professional		$20.42	$20.42	$28.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $151.36 / $181.97	Professional		$138.04	$151.36	$181.97
United Facility/Professional Facility Modifier Low / Median / High Price $10.96 / $14.45 / $21.88	Facility		$10.96	$14.45	$21.88
United Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $12.88 / $20.89	Professional		$8.51	$12.88	$20.89