Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $707.95 / $1,348.96	Facility		$87.10	$707.95	$1,348.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $707.95 / $707.95	Professional		$707.95	$707.95	$707.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $37.15 / $64.57	Professional		$30.20	$37.15	$64.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Facility		$64.57	$64.57	$64.57
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Facility		$64.57	$64.57	$64.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Professional		$60.26	$60.26	$60.26
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Facility		$72.44	$72.44	$72.44
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $70.79 / $75.86	Professional		$50.12	$70.79	$75.86
United Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $109.65 / $154.88	Facility		$44.67	$109.65	$154.88