Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $12.88 / $22.91	Facility		$12.88	$12.88	$22.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $12.88 / $21.88	Professional		$10.96	$12.88	$21.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $28.84 / $58.88	Facility		$27.54	$28.84	$58.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $17.78 / $34.67	Professional		$13.18	$17.78	$34.67
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $22.91 / $22.91	Professional		$22.91	$22.91	$22.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $14.79 / $22.39 / $35.48	Facility		$14.79	$22.39	$35.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $26.92 / $39.81	Professional		$19.50	$26.92	$39.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $16.98 / $16.98	Facility		$16.98	$16.98	$16.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $12.30 / $16.98	Professional		$12.30	$12.30	$16.98
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $16.98 / $16.98	Facility		$16.98	$16.98	$16.98
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $12.30 / $16.98	Professional		$12.30	$12.30	$16.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $16.60 / $23.44	Professional		$11.75	$16.60	$23.44
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $33.11 / $33.11	Facility		$33.11	$33.11	$33.11
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $30.90 / $57.54	Professional		$27.54	$30.90	$57.54
United Facility/Professional Facility Modifier Low / Median / High Price $11.48 / $19.05 / $28.84	Facility		$11.48	$19.05	$28.84
United Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $13.49 / $19.50	Professional		$8.91	$13.49	$19.50