Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $19.95 / $24.55	Facility		$14.13	$19.95	$24.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $12.88 / $21.88	Professional		$12.02	$12.88	$21.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $31.62 / $64.57	Facility		$30.20	$31.62	$64.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $11.48 / $37.15	Professional		$7.94	$11.48	$37.15
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $24.55 / $24.55	Professional		$24.55	$24.55	$24.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.49 / $18.62 / $44.67	Facility		$13.49	$18.62	$44.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $33.88 / $50.12	Professional		$24.55	$33.88	$50.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $22.39 / $22.39	Facility		$22.39	$22.39	$22.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $16.22 / $22.39	Professional		$16.22	$16.22	$22.39
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $22.39 / $22.39	Facility		$22.39	$22.39	$22.39
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $16.22 / $17.38	Professional		$16.22	$16.22	$17.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $21.38 / $29.51	Professional		$15.14	$21.38	$29.51
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $36.31 / $36.31	Facility		$36.31	$36.31	$36.31
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $33.11 / $60.26	Professional		$30.20	$33.11	$60.26
United Facility/Professional Facility Modifier Low / Median / High Price $10.47 / $20.89 / $41.69	Facility		$10.47	$20.89	$41.69
United Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $14.13 / $21.38	Professional		$9.55	$14.13	$21.38