Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $154.88	Facility		$93.33	$93.33	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $95.50 / $138.04	Professional		$72.44	$95.50	$138.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $77.62 / $173.78	Professional		$60.26	$77.62	$173.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $169.82 / $190.55	Facility		$147.91	$169.82	$190.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $199.53	Professional		$190.55	$190.55	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Professional		$60.26	$60.26	$60.26
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Professional		$60.26	$60.26	$60.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $47.86 / $75.86	Professional		$37.15	$47.86	$75.86
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $177.83 / $346.74	Professional		$151.36	$177.83	$346.74
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $69.18 / $91.20	Professional		$41.69	$69.18	$91.20