Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.99 / $800.60 / $3,174.00	Facility		$103.99	$800.60	$3,174.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $297.20 / $968.71 / $1,909.58	Facility	50	$297.20	$968.71	$1,909.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.24 / $94.70 / $203.49	Professional		$57.24	$94.70	$203.49
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $123.26 / $189.87 / $609.00	Professional	50	$123.26	$189.87	$609.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $55.70 / $91.61 / $128.25	Professional		$55.70	$91.61	$128.25
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $127.38 / $151.16 / $212.99	Professional	50	$127.38	$151.16	$212.99
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 $51.05 / $84.84 / $138.41	Professional		$51.05	$84.84	$138.41
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $76.56 / $127.26 / $207.82	Professional	50	$76.56	$127.26	$207.82
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $100.77 / $100.77 / $103.52	Professional		$100.77	$100.77	$103.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $55.96 / $67.15 / $83.94	Facility		$55.96	$67.15	$83.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $98.01 / $119.09 / $178.64	Professional		$98.01	$119.09	$178.64
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 $66.59 / $106.93 / $167.70	Professional		$66.59	$106.93	$167.70
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $229.29 / $514.05 / $827.00	Facility		$229.29	$514.05	$827.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $69.94 / $115.63 / $178.25	Professional		$69.94	$115.63	$178.25
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $206.70 / $297.00 / $466.65	Professional	50	$206.70	$297.00	$466.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.45 / $104.97 / $150.61	Professional		$79.45	$104.97	$150.61
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 $75.75 / $119.09 / $185.94	Professional		$75.75	$119.09	$185.94