Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.23 / $769.22 / $2,814.00	Facility		$87.23	$769.22	$2,814.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $652.36 / $1,314.24 / $3,746.35	Facility	50	$652.36	$1,314.24	$3,746.35
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $22.06 / $40.59 / $96.30	Facility	52	$22.06	$40.59	$96.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.11 / $74.04 / $161.28	Professional		$44.11	$74.04	$161.28
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $66.56 / $134.41 / $342.00	Professional	50	$66.56	$134.41	$342.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.86 / $60.54 / $87.92	Professional		$42.86	$60.54	$87.92
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $70.23 / $90.82 / $127.13	Professional	50	$70.23	$90.82	$127.13
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 $40.40 / $66.84 / $122.00	Professional		$40.40	$66.84	$122.00
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $60.60 / $100.22 / $183.30	Professional	50	$60.60	$100.22	$183.30
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $48.43 / $66.59 / $88.93	Professional		$48.43	$66.59	$88.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.86 / $51.43 / $64.29	Facility		$42.86	$51.43	$64.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.54 / $78.70 / $123.93	Professional		$61.54	$78.70	$123.93
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 $51.01 / $75.68 / $116.79	Professional		$51.01	$75.68	$116.79
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $196.63 / $462.52 / $1,208.31	Facility		$196.63	$462.52	$1,208.31
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $61.63 / $61.63 / $61.63	Facility	52	$61.63	$61.63	$61.63
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $53.58 / $79.15 / $120.14	Professional		$53.58	$79.15	$120.14
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $66.11 / $151.47 / $302.88	Professional	50	$66.11	$151.47	$302.88
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 $480.00 / $1,360.00 / $3,594.00	Facility		$480.00	$1,360.00	$3,594.00
United Facility/Professional Professional Modifier Low / Median / High Price $52.17 / $79.89 / $122.41	Professional		$52.17	$79.89	$122.41
United Facility/Professional Professional Modifier 50 Low / Median / High Price $80.00 / $80.00 / $136.40	Professional	50	$80.00	$80.00	$136.40