Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $114.82 / $125.89	Professional		$85.11	$114.82	$125.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $117.49 / $208.93	Professional		$100.00	$117.49	$208.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $186.21	Facility		$112.20	$112.20	$186.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $194.98	Professional		$186.21	$186.21	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Professional		$58.88	$58.88	$58.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Professional		$58.88	$58.88	$58.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $125.89 / $165.96	Professional		$79.43	$125.89	$165.96
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $154.88 / $245.47	Professional		$123.03	$154.88	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $67.61 / $89.13	Professional		$40.74	$67.61	$89.13