Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $37.15 / $63.10	Facility		$37.15	$37.15	$63.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $37.15 / $61.66	Professional		$32.36	$37.15	$61.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $81.28 / $165.96	Facility		$77.62	$81.28	$165.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $44.67 / $97.72	Professional		$37.15	$44.67	$97.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $57.54 / $91.20	Facility		$38.02	$57.54	$91.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $69.18 / $102.33	Professional		$50.12	$69.18	$102.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $43.65 / $43.65	Facility		$43.65	$43.65	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $37.15 / $43.65	Professional		$37.15	$37.15	$43.65
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $43.65 / $43.65	Facility		$43.65	$43.65	$43.65
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $37.15 / $43.65	Professional		$37.15	$37.15	$43.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $66.07 / $95.50	Professional		$41.69	$66.07	$95.50
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Facility		$93.33	$93.33	$93.33
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $87.10 / $158.49	Professional		$77.62	$87.10	$158.49
United Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $51.29 / $79.43	Facility		$28.18	$51.29	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $38.02 / $52.48	Professional		$25.12	$38.02	$52.48