Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $2,630.27 / $11,481.54	Facility		$602.56	$2,630.27	$11,481.54
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $851.14 / $891.25 / $2,089.30	Facility	50	$851.14	$891.25	$2,089.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $562.34 / $1,949.84	Professional		$426.58	$562.34	$1,949.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $537.03 / $575.44	Professional		$537.03	$537.03	$575.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $3,715.35 / $15,135.61	Facility		$1,548.82	$3,715.35	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $524.81 / $870.96	Professional		$416.87	$524.81	$870.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $549.54 / $630.96	Facility		$524.81	$549.54	$630.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $676.08 / $1,047.13	Professional		$194.98	$676.08	$1,047.13
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $676.08 / $1,047.13	Professional		$194.98	$676.08	$1,047.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $4,786.30	Facility		$100.00	$100.00	$4,786.30
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $602.56 / $1,148.15	Professional		$524.81	$602.56	$1,148.15
United Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $5,754.40 / $9,120.11	Facility		$2,884.03	$5,754.40	$9,120.11
United Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $575.44 / $1,000.00	Professional		$398.11	$575.44	$1,000.00