Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.46 / $388.80 / $844.98	Facility		$84.46	$388.80	$844.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.03 / $88.14 / $162.82	Professional		$57.03	$88.14	$162.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $650.03 / $650.03 / $650.03	Professional	50	$650.03	$650.03	$650.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.43 / $98.98 / $130.85	Professional		$78.43	$98.98	$130.85
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 $47.82 / $64.70 / $111.81	Professional		$47.82	$64.70	$111.81
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $71.73 / $97.06 / $168.43	Professional	50	$71.73	$97.06	$168.43
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $92.27 / $98.14 / $100.66	Professional		$92.27	$98.14	$100.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $59.72 / $71.66 / $89.58	Facility		$59.72	$71.66	$89.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.39 / $109.04 / $163.56	Professional		$89.39	$109.04	$163.56
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 $68.68 / $100.66 / $154.18	Professional		$68.68	$100.66	$154.18
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $106.72 / $284.16 / $444.90	Facility		$106.72	$284.16	$444.90
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $70.75 / $104.04 / $154.18	Professional		$70.75	$104.04	$154.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $106.30 / $150.61	Professional		$81.79	$106.30	$150.61
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $881.00 / $2,833.00	Facility		$444.00	$881.00	$2,833.00
United Facility/Professional Professional Modifier Low / Median / High Price $66.59 / $100.81 / $164.46	Professional		$66.59	$100.81	$164.46