Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $95.50 / $100.00	Facility		$53.70	$95.50	$100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $53.70 / $91.20	Professional		$43.65	$53.70	$91.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $109.65 / $223.87	Facility		$104.71	$109.65	$223.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $61.66 / $134.90	Professional		$50.12	$61.66	$134.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $79.43 / $128.82	Facility		$53.70	$79.43	$128.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $95.50 / $144.54	Professional		$69.18	$95.50	$144.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $66.07 / $66.07	Facility		$66.07	$66.07	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $66.07	Professional		$48.98	$48.98	$66.07
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $66.07 / $144.54	Facility		$66.07	$66.07	$144.54
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $66.07	Professional		$48.98	$48.98	$66.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $61.66 / $89.13	Professional		$44.67	$61.66	$89.13
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Facility		$125.89	$125.89	$125.89
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $117.49 / $213.80	Professional		$104.71	$117.49	$213.80
United Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $54.95 / $117.49	Facility		$42.66	$54.95	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $51.29 / $75.86	Professional		$33.88	$51.29	$75.86