Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $162.18 / $199.53	Professional		$83.18	$162.18	$199.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $125.89 / $275.42	Professional		$93.33	$125.89	$275.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $251.19	Facility		$169.82	$169.82	$251.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $257.04	Professional		$251.19	$251.19	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Professional		$91.20	$91.20	$91.20
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Professional		$91.20	$91.20	$91.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $104.71 / $144.54	Professional		$87.10	$104.71	$144.54
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $223.87 / $371.54	Professional		$190.55	$223.87	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $97.72 / $131.83	Professional		$63.10	$97.72	$131.83