Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $851.14 / $5,128.61	Facility		$60.26	$851.14	$5,128.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $72.44 / $162.18	Professional		$38.90	$72.44	$162.18
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $77.62 / $109.65 / $204.17	Professional	50	$77.62	$109.65	$204.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $57.54 / $104.71	Professional		$50.12	$57.54	$104.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,137.96 / $3,981.07	Facility		$707.95	$2,137.96	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $56.23 / $93.33	Professional		$38.90	$56.23	$93.33
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $58.88 / $85.11 / $138.04	Professional	50	$58.88	$85.11	$138.04
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $66.07 / $77.62	Professional		$38.90	$66.07	$77.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $46.77 / $61.66	Facility		$36.31	$46.77	$61.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $72.44 / $125.89	Professional		$54.95	$72.44	$125.89
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 $42.66 / $64.57 / $102.33	Professional		$42.66	$64.57	$102.33
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $407.38 / $831.76	Facility		$131.83	$407.38	$831.76
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $66.07 / $102.33	Professional		$43.65	$66.07	$102.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $37.15	Professional		$32.36	$33.11	$37.15
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $380.19	Facility		$100.00	$100.00	$380.19
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $60.26 / $102.33	Professional		$33.88	$60.26	$102.33
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $912.01 / $2,951.21	Facility		$316.23	$912.01	$2,951.21
United Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $54.95 / $89.13	Professional		$34.67	$54.95	$89.13