Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.63 / $338.14 / $4,275.00	Facility		$83.63	$338.14	$4,275.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.62 / $105.95 / $231.25	Professional		$58.62	$105.95	$231.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $241.97 / $241.97 / $241.97	Professional	50	$241.97	$241.97	$241.97
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $29.31 / $47.71 / $76.84	Professional	52	$29.31	$47.71	$76.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.99 / $102.32 / $153.66	Professional		$82.99	$102.32	$153.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,927.00 / $3,943.00	Facility		$937.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $81.22 / $149.81	Professional		$44.14	$81.22	$149.81
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $66.20 / $121.83 / $224.72	Professional	50	$66.20	$121.83	$224.72
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $62.40 / $112.68 / $120.39	Professional		$62.40	$112.68	$120.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.84 / $79.80 / $93.47	Facility		$63.84	$79.80	$93.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $107.44 / $138.29 / $168.72	Professional		$107.44	$138.29	$168.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,571.00 / $21,571.00 / $21,571.00	Facility		$21,571.00	$21,571.00	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.01 / $102.44 / $180.69	Professional		$60.01	$102.44	$180.69
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $72.25 / $130.69 / $587.10	Facility		$72.25	$130.69	$587.10
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $72.02 / $110.42 / $184.15	Professional		$72.02	$110.42	$184.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $89.08 / $128.11 / $188.31	Professional		$89.08	$128.11	$188.31
United Facility/Professional Facility Modifier Low / Median / High Price $149.26 / $738.00 / $2,816.00	Facility		$149.26	$738.00	$2,816.00
United Facility/Professional Professional Modifier Low / Median / High Price $85.80 / $114.40 / $186.97	Professional		$85.80	$114.40	$186.97