Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $53.70 / $67.61	Facility		$37.15	$53.70	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $36.31 / $53.70	Professional		$28.18	$36.31	$53.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $75.86 / $154.88	Facility		$72.44	$75.86	$154.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $40.74 / $91.20	Professional		$34.67	$40.74	$91.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $53.70 / $85.11	Facility		$35.48	$53.70	$85.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $63.10 / $95.50	Professional		$45.71	$63.10	$95.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $38.90	Facility		$38.90	$38.90	$38.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $28.84 / $38.90	Professional		$28.84	$28.84	$38.90
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $95.50	Facility		$38.90	$38.90	$95.50
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $28.84 / $38.90	Professional		$28.84	$28.84	$38.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $20.42 / $28.84	Professional		$14.45	$20.42	$28.84
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $81.28 / $147.91	Professional		$72.44	$81.28	$147.91
United Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $33.88 / $72.44	Facility		$23.99	$33.88	$72.44
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $33.11 / $47.86	Professional		$23.44	$33.11	$47.86