Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $28.18 / $48.98	Facility		$28.18	$28.18	$48.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $33.11 / $52.48	Professional		$25.70	$33.11	$52.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $63.10 / $128.82	Facility		$60.26	$63.10	$128.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $36.31 / $77.62	Professional		$29.51	$36.31	$77.62
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 $50.12 / $70.79 / $104.71	Professional		$50.12	$70.79	$104.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $37.15 / $37.15	Facility		$37.15	$37.15	$37.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $26.92 / $37.15	Professional		$26.92	$26.92	$37.15
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $37.15 / $37.15	Facility		$37.15	$37.15	$37.15
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $26.92 / $37.15	Professional		$26.92	$26.92	$37.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $36.31 / $51.29	Professional		$25.70	$36.31	$51.29
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Facility		$72.44	$72.44	$72.44
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $67.61 / $125.89	Professional		$60.26	$67.61	$125.89
United Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $44.67 / $69.18	Facility		$26.92	$44.67	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $29.51 / $45.71	Professional		$19.50	$29.51	$45.71