Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $36.31 / $52.48	Facility		$36.31	$36.31	$52.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $37.15 / $57.54	Professional		$28.84	$37.15	$57.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $79.43 / $162.18	Facility		$75.86	$79.43	$162.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $43.65 / $95.50	Professional		$37.15	$43.65	$95.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $58.88 / $93.33	Facility		$38.90	$58.88	$93.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $70.79 / $107.15	Professional		$51.29	$70.79	$107.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $47.86 / $47.86	Facility		$47.86	$47.86	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $47.86	Professional		$35.48	$35.48	$47.86
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $47.86 / $47.86	Facility		$47.86	$47.86	$47.86
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $47.86	Professional		$35.48	$35.48	$47.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $47.86 / $69.18	Professional		$33.88	$47.86	$69.18
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $85.11 / $154.88	Professional		$75.86	$85.11	$154.88
United Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $47.86 / $74.13	Facility		$26.92	$47.86	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $37.15 / $48.98	Professional		$24.55	$37.15	$48.98