Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $1,148.15 / $4,168.69	Facility		$138.04	$1,148.15	$4,168.69
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,691.53 / $2,691.53 / $2,691.53	Facility	50	$2,691.53	$2,691.53	$2,691.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $144.54 / $407.38	Professional		$48.98	$144.54	$407.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.38 / $169.82 / $575.44	Professional	50	$17.38	$169.82	$575.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $102.33 / $165.96	Professional		$42.66	$102.33	$165.96
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $77.62 / $77.62 / $77.62	Professional	50	$77.62	$77.62	$77.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $58.88 / $109.65	Professional		$40.74	$58.88	$109.65
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $61.66 / $87.10 / $162.18	Professional	50	$61.66	$87.10	$162.18
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $53.70 / $53.70	Professional		$48.98	$53.70	$53.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $64.57 / $83.18	Facility		$45.71	$64.57	$83.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $177.83 / $234.42	Professional		$141.25	$177.83	$234.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $85.11 / $21,379.62	Facility		$42.66	$85.11	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $144.54 / $288.40	Professional		$53.70	$144.54	$288.40
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $363.08 / $741.31	Facility		$85.11	$363.08	$741.31
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $134.90 / $288.40	Professional		$53.70	$134.90	$288.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $154.88 / $288.40	Professional		$45.71	$154.88	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $954.99 / $3,019.95	Facility		$316.23	$954.99	$3,019.95
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $131.83 / $263.03	Professional		$52.48	$131.83	$263.03