Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $45.71 / $58.88	Facility		$20.89	$45.71	$58.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $20.89 / $44.67	Professional		$19.95	$20.89	$44.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $33.88 / $74.13	Facility		$22.39	$33.88	$74.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $23.99 / $35.48	Professional		$20.89	$23.99	$35.48
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $20.42 / $20.42	Professional		$20.42	$20.42	$20.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $26.30 / $26.30	Facility		$26.30	$26.30	$26.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $26.30 / $35.48	Professional		$21.88	$26.30	$35.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $15.14 / $57.54	Facility		$15.14	$15.14	$57.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $20.89 / $27.54	Professional		$20.89	$20.89	$27.54
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $20.89 / $72.44	Facility		$15.14	$20.89	$72.44
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $20.89 / $40.74	Professional		$20.89	$20.89	$40.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $26.30 / $34.67	Professional		$20.89	$26.30	$34.67
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $25.12 / $46.77	Professional		$21.38	$25.12	$46.77
United Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $20.89 / $26.30	Facility		$20.89	$20.89	$26.30
United Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $22.39 / $34.67	Professional		$20.89	$22.39	$34.67