Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $79.43	Facility		$67.61	$67.61	$79.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $67.61 / $89.13	Professional		$67.61	$67.61	$89.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $75.86 / $134.90	Professional		$57.54	$75.86	$134.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Facility		$69.18	$69.18	$69.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $93.33	Professional		$69.18	$69.18	$93.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $69.18	Facility		$64.57	$64.57	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $79.43	Professional		$69.18	$69.18	$79.43
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $69.18	Facility		$64.57	$64.57	$69.18
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $91.20	Professional		$69.18	$69.18	$91.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $93.33 / $128.82	Professional		$75.86	$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 $56.23 / $64.57 / $123.03	Professional		$56.23	$64.57	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $69.18 / $125.89	Professional		$50.12	$69.18	$125.89