Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $87.10	Facility		$75.86	$75.86	$87.10
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 / $93.33 / $169.82	Professional		$75.86	$93.33	$169.82
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 $70.79 / $70.79 / $75.86	Facility		$70.79	$70.79	$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 $70.79 / $70.79 / $75.86	Facility		$70.79	$70.79	$75.86
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $128.82	Professional		$75.86	$75.86	$128.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $95.50 / $128.82	Professional		$75.86	$95.50	$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 $123.03 / $144.54 / $1,380.38	Professional		$123.03	$144.54	$1,380.38
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $125.89 / $954.99	Professional		$70.79	$125.89	$954.99