Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.35 / $166.94 / $495.84	Facility		$38.35	$166.94	$495.84
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $219.42 / $419.20 / $1,087.23	Facility	50	$219.42	$419.20	$1,087.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.57 / $48.96 / $103.14	Professional		$25.57	$48.96	$103.14
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $69.08 / $90.21 / $355.50	Professional	50	$69.08	$90.21	$355.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $54.64 / $89.14	Professional		$29.51	$54.64	$89.14
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $61.47 / $81.96 / $86.27	Professional	50	$61.47	$81.96	$86.27
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 $23.33 / $31.49 / $54.77	Professional		$23.33	$31.49	$54.77
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $34.99 / $47.22 / $82.16	Professional	50	$34.99	$47.22	$82.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.80 / $29.76 / $37.20	Facility		$24.80	$29.76	$37.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.76 / $74.76 / $112.14	Professional		$59.76	$74.76	$112.14
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 $30.51 / $61.51 / $103.90	Professional		$30.51	$61.51	$103.90
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $188.48 / $345.18 / $625.92	Facility		$188.48	$345.18	$625.92
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $29.77 / $60.47 / $96.36	Professional		$29.77	$60.47	$96.36
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $80.59 / $80.59 / $80.59	Professional	50	$80.59	$80.59	$80.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.98 / $71.09 / $101.43	Professional		$52.98	$71.09	$101.43
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 $47.42 / $70.37 / $121.54	Professional		$47.42	$70.37	$121.54