Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $13.64 / $13.64 / $107.00	Facility		$13.64	$13.64	$107.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.64 / $13.64 / $14.49	Professional		$13.64	$13.64	$14.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.05 / $19.09 / $28.18	Professional		$17.05	$19.09	$28.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.02 / $23.02 / $39.13	Facility		$23.02	$23.02	$39.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $17.05 / $23.02 / $23.02	Professional		$17.05	$23.02	$23.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $17.05 / $17.05 / $17.05	Facility		$17.05	$17.05	$17.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.05 / $17.05 / $17.05	Professional		$17.05	$17.05	$17.05
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $70.00 / $70.00	Facility		$70.00	$70.00	$70.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $17.05 / $17.05 / $20.11	Professional		$17.05	$17.05	$20.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.75 / $50.00 / $60.00	Professional		$18.75	$50.00	$60.00
United Facility/Professional Facility Modifier Low / Median / High Price $16.70 / $16.70 / $16.70	Facility		$16.70	$16.70	$16.70
United Facility/Professional Professional Modifier Low / Median / High Price $17.05 / $17.05 / $22.34	Professional		$17.05	$17.05	$22.34