Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.02 / $12.02 / $23.99	Facility		$12.02	$12.02	$23.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $12.88 / $20.89	Professional		$10.96	$12.88	$20.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $27.54 / $56.23	Facility		$26.30	$27.54	$56.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $15.85 / $33.88	Professional		$12.88	$15.85	$33.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $19.50 / $30.90	Facility		$12.88	$19.50	$30.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $22.91 / $34.67	Professional		$16.60	$22.91	$34.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.22 / $16.22 / $16.22	Facility		$16.22	$16.22	$16.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $12.02 / $16.22	Professional		$12.02	$12.02	$16.22
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $16.22 / $16.22 / $16.22	Facility		$16.22	$16.22	$16.22
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $12.02 / $16.22	Professional		$12.02	$12.02	$16.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $15.85 / $22.39	Professional		$11.22	$15.85	$22.39
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $31.62 / $31.62	Facility		$31.62	$31.62	$31.62
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $29.51 / $53.70	Professional		$26.30	$29.51	$53.70
United Facility/Professional Facility Modifier Low / Median / High Price $11.22 / $19.50 / $29.51	Facility		$11.22	$19.50	$29.51
United Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $12.88 / $19.95	Professional		$8.51	$12.88	$19.95