Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $119.70 / $1,109.00 / $4,642.34	Facility		$119.70	$1,109.00	$4,642.34
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $747.68 / $747.68 / $2,424.02	Facility	50	$747.68	$747.68	$2,424.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.12 / $187.43 / $366.49	Professional		$64.12	$187.43	$366.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.48 / $121.97 / $209.35	Professional		$58.48	$121.97	$209.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.17 / $79.13 / $146.25	Professional		$54.17	$79.13	$146.25
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $80.66 / $117.67 / $218.26	Professional	50	$80.66	$117.67	$218.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $64.19 / $77.03 / $103.87	Facility		$64.19	$77.03	$103.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $201.81 / $255.25 / $332.99	Professional		$201.81	$255.25	$332.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.83 / $115.83 / $21,571.00	Facility		$115.83	$115.83	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.59 / $163.69 / $383.98	Professional		$73.59	$163.69	$383.98
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $115.83 / $273.05 / $729.79	Facility		$115.83	$273.05	$729.79
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $75.59 / $147.63 / $363.64	Professional		$75.59	$147.63	$363.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $164.96 / $217.73 / $304.21	Professional		$164.96	$217.73	$304.21
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $1,009.00 / $3,218.00	Facility		$444.00	$1,009.00	$3,218.00
United Facility/Professional Professional Modifier Low / Median / High Price $193.37 / $273.01 / $548.34	Professional		$193.37	$273.01	$548.34