Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $5,011.87 / $10,471.29	Facility		$776.25	$5,011.87	$10,471.29
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,801.89 / $8,709.64 / $19,498.45	Facility	50	$3,801.89	$8,709.64	$19,498.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $707.95 / $1,778.28	Professional		$467.74	$707.95	$1,778.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $537.03 / $870.96	Professional		$407.38	$537.03	$870.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $3,311.31 / $7,943.28	Facility		$1,348.96	$3,311.31	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $537.03 / $870.96	Professional		$407.38	$537.03	$870.96
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $562.34 / $741.31	Professional		$549.54	$562.34	$741.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $630.96 / $831.76	Facility		$489.78	$630.96	$831.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $660.69 / $1,174.90	Professional		$501.19	$660.69	$1,174.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $676.08 / $977.24	Professional		$489.78	$676.08	$977.24
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $3,090.30 / $7,413.10	Facility		$1,380.38	$3,090.30	$7,413.10
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $660.69 / $1,000.00	Professional		$478.63	$660.69	$1,000.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $69.18	Professional		$32.36	$33.11	$69.18
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,995.26 / $2,089.30	Facility		$100.00	$1,995.26	$2,089.30
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $575.44 / $933.25	Professional		$489.78	$575.44	$933.25
United Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $5,754.40 / $8,511.38	Facility		$2,818.38	$5,754.40	$8,511.38
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $562.34 / $891.25	Professional		$371.54	$562.34	$891.25