Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.55 / $707.20 / $3,847.00	Facility		$78.55	$707.20	$3,847.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $457.61 / $644.21 / $766.00	Facility	50	$457.61	$644.21	$766.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.71 / $71.02 / $139.44	Professional		$42.71	$71.02	$139.44
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $66.42 / $111.59 / $239.39	Professional	50	$66.42	$111.59	$239.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.69 / $76.70 / $112.67	Professional		$53.69	$76.70	$112.67
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $111.90 / $115.06 / $115.06	Professional	50	$111.90	$115.06	$115.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $814.00 / $1,927.00 / $3,943.00	Facility		$814.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.42 / $65.86 / $109.76	Professional		$38.42	$65.86	$109.76
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $57.63 / $98.80 / $164.65	Professional	50	$57.63	$98.80	$164.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $44.00 / $52.80 / $66.00	Facility		$44.00	$52.80	$66.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $78.87 / $99.71 / $155.55	Professional		$78.87	$99.71	$155.55
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 $52.35 / $83.78 / $136.18	Professional		$52.35	$83.78	$136.18
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $79.31 / $388.98 / $943.32	Facility		$79.31	$388.98	$943.32
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $52.79 / $84.38 / $136.38	Professional		$52.79	$84.38	$136.38
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $115.32 / $115.32 / $115.32	Professional	50	$115.32	$115.32	$115.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $53.47 / $71.09 / $101.43	Professional		$53.47	$71.09	$101.43
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $965.00 / $2,914.00	Facility		$444.00	$965.00	$2,914.00
United Facility/Professional Professional Modifier Low / Median / High Price $60.30 / $94.53 / $145.37	Professional		$60.30	$94.53	$145.37