Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $58.88 / $79.43	Professional		$33.11	$58.88	$79.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $52.48 / $93.33	Professional		$36.31	$52.48	$93.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Facility		$95.50	$95.50	$95.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $97.72	Professional		$95.50	$95.50	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $34.67 / $34.67	Professional		$34.67	$34.67	$34.67
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $34.67 / $34.67	Professional		$34.67	$34.67	$34.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $48.98 / $72.44	Professional		$44.67	$48.98	$72.44
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $75.86 / $125.89	Professional		$63.10	$75.86	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $35.48 / $44.67	Professional		$24.55	$35.48	$44.67