Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $89.13 / $102.33	Professional		$43.65	$89.13	$102.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $66.07 / $147.91	Professional		$50.12	$66.07	$147.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $147.91	Facility		$95.50	$95.50	$147.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $154.88	Professional		$147.91	$147.91	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $51.29	Professional		$51.29	$51.29	$51.29
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $51.29	Professional		$51.29	$51.29	$51.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $97.72 / $128.82	Professional		$61.66	$97.72	$128.82
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $120.23 / $199.53	Professional		$100.00	$120.23	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $53.70 / $69.18	Professional		$35.48	$53.70	$69.18