Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.39 / $776.88 / $2,756.00	Facility		$78.39	$776.88	$2,756.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $600.23 / $1,723.40 / $3,752.74	Facility	50	$600.23	$1,723.40	$3,752.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.74 / $58.36 / $113.09	Professional		$35.74	$58.36	$113.09
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $77.51 / $123.24 / $409.50	Professional	50	$77.51	$123.24	$409.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.95 / $48.57 / $76.34	Professional		$32.95	$48.57	$76.34
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $67.65 / $74.69 / $104.57	Professional	50	$67.65	$74.69	$104.57
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 $33.90 / $54.96 / $100.12	Professional		$33.90	$54.96	$100.12
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $50.85 / $82.44 / $150.34	Professional	50	$50.85	$82.44	$150.34
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $39.20 / $57.51 / $61.07	Professional		$39.20	$57.51	$61.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $34.69 / $41.63 / $52.04	Facility		$34.69	$41.63	$52.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.28 / $66.16 / $103.54	Professional		$52.28	$66.16	$103.54
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 $41.28 / $62.84 / $98.07	Professional		$41.28	$62.84	$98.07
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $173.27 / $464.78 / $1,241.17	Facility		$173.27	$464.78	$1,241.17
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $43.36 / $64.65 / $97.38	Professional		$43.36	$64.65	$97.38
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $76.28 / $76.28 / $307.13	Professional	50	$76.28	$76.28	$307.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.98 / $71.09 / $101.43	Professional		$52.98	$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 $42.34 / $65.61 / $103.97	Professional		$42.34	$65.61	$103.97