Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $72.44 / $616.60	Facility		$41.69	$72.44	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $42.66 / $72.44	Professional		$37.15	$42.66	$72.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $95.50 / $190.55	Facility		$89.13	$95.50	$190.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $52.48 / $114.82	Professional		$43.65	$52.48	$114.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $66.07 / $107.15	Facility		$43.65	$66.07	$107.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $79.43 / $120.23	Professional		$57.54	$79.43	$120.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Facility		$69.18	$69.18	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $69.18	Professional		$58.88	$58.88	$69.18
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Facility		$69.18	$69.18	$69.18
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $69.18	Professional		$58.88	$58.88	$69.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $75.86 / $109.65	Professional		$47.86	$75.86	$109.65
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Facility		$107.15	$107.15	$107.15
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $100.00 / $186.21	Professional		$89.13	$100.00	$186.21
United Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $58.88 / $91.20	Facility		$32.36	$58.88	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $43.65 / $60.26	Professional		$29.51	$43.65	$60.26