Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $616.60 / $4,786.30	Facility		$354.81	$616.60	$4,786.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $457.09 / $891.25	Professional		$302.00	$457.09	$891.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $616.60 / $1,047.13 / $1,659.59	Professional	50	$616.60	$1,047.13	$1,659.59
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $281.84 / $398.11 / $616.60	Professional	54	$281.84	$398.11	$616.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $323.59 / $426.58	Professional		$257.04	$323.59	$426.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,137.96 / $3,981.07	Facility		$707.95	$2,137.96	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $281.84 / $478.63	Professional		$208.93	$281.84	$478.63
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $316.23 / $426.58 / $707.95	Professional	50	$316.23	$426.58	$707.95
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $426.58 / $436.52	Professional		$389.05	$426.58	$436.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $407.38 / $524.81	Facility		$316.23	$407.38	$524.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $446.68 / $776.25	Professional		$338.84	$446.68	$776.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $426.58 / $630.96	Professional		$295.12	$426.58	$630.96
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $354.81 / $630.96	Facility		$194.98	$354.81	$630.96
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $426.58 / $630.96	Professional		$302.00	$426.58	$630.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $190.55	Professional		$32.36	$33.11	$190.55
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $302.00	Facility		$100.00	$100.00	$302.00
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $407.38 / $758.58	Professional		$309.03	$407.38	$758.58
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $912.01 / $2,951.21	Facility		$316.23	$912.01	$2,951.21
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $338.84 / $549.54	Professional		$229.09	$338.84	$549.54