Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $38.02 / $72.44	Facility		$38.02	$38.02	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $41.69 / $66.07	Professional		$33.88	$41.69	$66.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $83.18 / $169.82	Facility		$79.43	$83.18	$169.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $52.48 / $100.00	Professional		$38.90	$52.48	$100.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $67.61 / $107.15	Facility		$44.67	$67.61	$107.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $81.28 / $120.23	Professional		$58.88	$81.28	$120.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Facility		$48.98	$48.98	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $48.98	Professional		$35.48	$35.48	$48.98
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Facility		$48.98	$48.98	$48.98
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $48.98	Professional		$35.48	$35.48	$48.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $47.86 / $67.61	Professional		$33.88	$47.86	$67.61
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Facility		$95.50	$95.50	$95.50
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $89.13 / $162.18	Professional		$79.43	$89.13	$162.18
United Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $58.88 / $89.13	Facility		$32.36	$58.88	$89.13
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $38.90 / $60.26	Professional		$25.70	$38.90	$60.26