Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $72.44	Facility		$61.66	$61.66	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $85.11	Professional		$61.66	$61.66	$85.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $77.62 / $151.36	Professional		$63.10	$77.62	$151.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Facility		$63.10	$63.10	$63.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $85.11	Professional		$63.10	$63.10	$85.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $63.10	Facility		$58.88	$58.88	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $89.13	Professional		$63.10	$63.10	$89.13
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $63.10	Facility		$58.88	$58.88	$63.10
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $89.13	Professional		$63.10	$63.10	$89.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $93.33 / $128.82	Professional		$69.18	$93.33	$128.82
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 $91.20 / $107.15 / $199.53	Professional		$91.20	$107.15	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $81.28 / $125.89	Professional		$63.10	$81.28	$125.89