Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $146.13 / $1,338.75 / $3,722.64	Facility		$146.13	$1,338.75	$3,722.64
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $974.78 / $2,613.23 / $4,070.92	Facility	50	$974.78	$2,613.23	$4,070.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.25 / $151.49 / $273.35	Professional		$69.25	$151.49	$273.35
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $122.06 / $264.77 / $659.15	Professional	50	$122.06	$264.77	$659.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $71.94 / $90.30 / $149.83	Professional		$71.94	$90.30	$149.83
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $141.34 / $141.34 / $350.60	Professional	50	$141.34	$141.34	$350.60
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 $55.02 / $82.50 / $135.29	Professional		$55.02	$82.50	$135.29
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $82.53 / $123.34 / $202.93	Professional	50	$82.53	$123.34	$202.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $78.52 / $94.22 / $117.78	Facility		$78.52	$94.22	$117.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $155.77 / $194.78 / $303.41	Professional		$155.77	$194.78	$303.41
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 $90.30 / $161.50 / $305.99	Professional		$90.30	$161.50	$305.99
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $648.77 / $1,567.49 / $3,118.40	Facility		$648.77	$1,567.49	$3,118.40
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $90.30 / $164.82 / $305.99	Professional		$90.30	$164.82	$305.99
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $119.22 / $283.76 / $380.28	Professional	50	$119.22	$283.76	$380.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $105.44 / $141.63 / $199.39	Professional		$105.44	$141.63	$199.39
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 $131.60 / $203.74 / $319.36	Professional		$131.60	$203.74	$319.36