Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $89.13	Facility		$75.86	$75.86	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $100.00	Professional		$75.86	$75.86	$100.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $91.20 / $162.18	Professional		$75.86	$91.20	$162.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Facility		$75.86	$75.86	$75.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $102.33	Professional		$75.86	$75.86	$102.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $75.86	Facility		$72.44	$72.44	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $107.15	Professional		$75.86	$75.86	$107.15
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $75.86	Facility		$72.44	$72.44	$75.86
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $131.83	Professional		$75.86	$75.86	$131.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $97.72 / $131.83	Professional		$79.43	$97.72	$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 $123.03 / $144.54 / $269.15	Professional		$123.03	$144.54	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $125.89 / $302.00	Professional		$87.10	$125.89	$302.00