Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $93.33 / $102.33	Professional		$41.69	$93.33	$102.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $72.44 / $158.49	Professional		$54.95	$72.44	$158.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $154.88	Facility		$91.20	$91.20	$154.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $158.49	Professional		$154.88	$154.88	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Professional		$48.98	$48.98	$48.98
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Professional		$48.98	$48.98	$48.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $109.65 / $144.54	Professional		$70.79	$109.65	$144.54
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $131.83 / $218.78	Professional		$109.65	$131.83	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $51.29 / $74.13	Professional		$33.88	$51.29	$74.13