Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.75 / $33.75 / $111.00	Facility		$33.75	$33.75	$111.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.53 / $33.75 / $38.65	Professional		$29.53	$33.75	$38.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $59.01 / $69.12 / $179.09	Facility		$59.01	$69.12	$179.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.65 / $33.04 / $82.57	Professional		$30.65	$33.04	$82.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.13 / $62.84 / $84.83	Facility		$47.13	$62.84	$84.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.05 / $56.84 / $134.55	Professional		$41.05	$56.84	$134.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.07 / $35.07 / $74.00	Facility		$35.07	$35.07	$74.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.60 / $25.60 / $35.07	Professional		$25.60	$25.60	$35.07
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $35.07 / $35.07 / $35.07	Facility		$35.07	$35.07	$35.07
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $25.60 / $35.07 / $35.07	Professional		$25.60	$35.07	$35.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.85 / $47.92 / $62.83	Professional		$34.85	$47.92	$62.83
United Facility/Professional Professional Modifier Low / Median / High Price $20.90 / $29.52 / $42.18	Professional		$20.90	$29.52	$42.18