Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $158.49 / $208.93	Professional		$83.18	$158.49	$208.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $125.89 / $323.59	Professional		$109.65	$125.89	$323.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $245.47	Facility		$169.82	$169.82	$245.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $257.04	Professional		$245.47	$245.47	$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 $117.49 / $141.25 / $194.98	Professional		$117.49	$141.25	$194.98
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $263.03 / $436.52	Professional		$218.78	$263.03	$436.52
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $100.00 / $151.36	Professional		$63.10	$100.00	$151.36