Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $91.20	Facility		$53.70	$53.70	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $54.95 / $89.13	Professional		$46.77	$54.95	$89.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $120.23 / $239.88	Facility		$112.20	$120.23	$239.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $74.13 / $144.54	Professional		$54.95	$74.13	$144.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $83.18 / $134.90	Facility		$56.23	$83.18	$134.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $100.00 / $151.36	Professional		$72.44	$100.00	$151.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $87.10	Professional		$74.13	$74.13	$87.10
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Professional		$74.13	$74.13	$74.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $81.28 / $114.82	Professional		$57.54	$81.28	$114.82
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $125.89 / $234.42	Professional		$112.20	$125.89	$234.42
United Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $74.13 / $114.82	Facility		$40.74	$74.13	$114.82
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $54.95 / $75.86	Professional		$37.15	$54.95	$75.86