Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $92.17 / $495.84	Facility		$19.50	$92.17	$495.84
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $460.60 / $546.65 / $546.65	Facility	50	$460.60	$546.65	$546.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.73 / $26.75 / $46.33	Professional		$16.73	$26.75	$46.33
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $42.18 / $48.35 / $85.96	Professional	50	$42.18	$48.35	$85.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.73 / $25.28 / $34.18	Professional		$18.73	$25.28	$34.18
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $37.46 / $37.46 / $37.46	Professional	50	$37.46	$37.46	$37.46
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 $20.55 / $25.83 / $44.81	Professional		$20.55	$25.83	$44.81
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $30.82 / $38.65 / $67.73	Professional	50	$30.82	$38.65	$67.73
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $29.71 / $29.71 / $29.71	Professional		$29.71	$29.71	$29.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.55 / $19.87 / $24.84	Facility		$16.55	$19.87	$24.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.27 / $34.18 / $51.27	Professional		$28.27	$34.18	$51.27
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 $20.05 / $36.36 / $70.34	Professional		$20.05	$36.36	$70.34
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $30.07 / $200.22 / $467.00	Facility		$30.07	$200.22	$467.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $19.88 / $33.26 / $54.78	Professional		$19.88	$33.26	$54.78
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $35.43 / $35.43 / $35.72	Professional	50	$35.43	$35.43	$35.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.91 / $15.19 / $24.77	Professional		$12.91	$15.19	$24.77
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 $23.38 / $38.20 / $61.20	Professional		$23.38	$38.20	$61.20