Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $21.88 / $21.88	Facility		$21.88	$21.88	$21.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $22.91 / $26.30	Professional		$21.88	$22.91	$26.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $21.88 / $63.10	Professional		$16.98	$21.88	$63.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $295.12 / $346.74	Facility		$295.12	$295.12	$346.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Professional		$295.12	$295.12	$295.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $24.55 / $24.55	Facility		$24.55	$24.55	$24.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $24.55 / $24.55	Professional		$24.55	$24.55	$24.55
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $24.55 / $24.55	Facility		$24.55	$24.55	$24.55
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $24.55 / $28.84	Professional		$24.55	$24.55	$28.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $33.11 / $131.83	Professional		$18.62	$33.11	$131.83
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $144.54 / $158.49	Facility		$134.90	$144.54	$158.49
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $34.67 / $70.79	Professional		$22.39	$34.67	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $28.84 / $125.89	Professional		$28.84	$28.84	$125.89