Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $79.43	Facility		$53.70	$53.70	$79.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $53.70 / $83.18	Professional		$40.74	$53.70	$83.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $120.23 / $245.47	Facility		$114.82	$120.23	$245.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $66.07 / $144.54	Professional		$56.23	$66.07	$144.54
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $72.44 / $114.82	Facility		$47.86	$72.44	$114.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $87.10 / $128.82	Professional		$63.10	$87.10	$128.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Facility		$60.26	$60.26	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $60.26	Professional		$43.65	$43.65	$60.26
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Facility		$60.26	$60.26	$60.26
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $60.26	Professional		$43.65	$43.65	$60.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $69.18 / $97.72	Professional		$48.98	$69.18	$97.72
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Facility		$138.04	$138.04	$138.04
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $128.82 / $234.42	Professional		$114.82	$128.82	$234.42
United Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $72.44 / $112.20	Facility		$43.65	$72.44	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $54.95 / $74.13	Professional		$37.15	$54.95	$74.13