Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $61.66 / $120.23	Facility		$18.20	$61.66	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $48.98 / $77.62	Professional		$37.15	$48.98	$77.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $100.00 / $204.17	Facility		$95.50	$100.00	$204.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $54.95 / $120.23	Professional		$45.71	$54.95	$120.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $70.79 / $112.20	Facility		$46.77	$70.79	$112.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $85.11 / $125.89	Professional		$60.26	$85.11	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $56.23 / $64.57	Facility		$56.23	$56.23	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $41.69 / $56.23	Professional		$41.69	$41.69	$56.23
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $56.23 / $125.89	Facility		$56.23	$56.23	$125.89
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $41.69 / $56.23	Professional		$41.69	$41.69	$56.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $72.44 / $104.71	Professional		$51.29	$72.44	$104.71
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $107.15 / $194.98	Professional		$95.50	$107.15	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $44.67 / $95.50	Facility		$31.62	$44.67	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $44.67 / $63.10	Professional		$30.90	$44.67	$63.10