Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $38.02 / $64.57	Facility		$38.02	$38.02	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $38.02 / $64.57	Professional		$33.11	$38.02	$64.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $83.18 / $169.82	Facility		$79.43	$83.18	$169.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $52.48 / $117.49	Professional		$38.90	$52.48	$117.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $58.88 / $93.33	Facility		$38.90	$58.88	$93.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $70.79 / $107.15	Professional		$51.29	$70.79	$107.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Facility		$61.66	$61.66	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $61.66	Professional		$52.48	$52.48	$61.66
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Facility		$61.66	$61.66	$61.66
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Professional		$52.48	$52.48	$52.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $53.70 / $77.62	Professional		$38.90	$53.70	$77.62
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Facility		$95.50	$95.50	$95.50
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $89.13 / $165.96	Professional		$79.43	$89.13	$165.96
United Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $52.48 / $81.28	Facility		$31.62	$52.48	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $38.90 / $53.70	Professional		$25.70	$38.90	$53.70