Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $992.75 / $5,851.00 / $11,581.00	Facility		$992.75	$5,851.00	$11,581.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,250.92 / $10,539.00 / $10,539.00	Facility	50	$4,250.92	$10,539.00	$10,539.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $547.07 / $654.89 / $1,822.14	Professional		$547.07	$654.89	$1,822.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $348.20 / $535.69 / $749.97	Professional		$348.20	$535.69	$749.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,009.00 / $5,668.00 / $14,996.00	Facility		$2,009.00	$5,668.00	$14,996.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $549.88 / $750.42 / $1,187.56	Professional		$549.88	$750.42	$1,187.56
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $605.33 / $642.83 / $642.83	Professional		$605.33	$642.83	$642.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $535.69 / $642.83 / $803.54	Facility		$535.69	$642.83	$803.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $563.88 / $696.40 / $1,044.59	Professional		$563.88	$696.40	$1,044.59
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 $562.47 / $809.94 / $1,137.70	Professional		$562.47	$809.94	$1,137.70
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,980.38 / $3,665.25 / $9,793.79	Facility		$1,980.38	$3,665.25	$9,793.79
Medical Mutual of Ohio Facility/Professional Facility Modifier AS Low / Median / High Price $63.83 / $63.83 / $63.83	Facility	AS	$63.83	$63.83	$63.83
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $538.32 / $817.90 / $1,184.30	Professional		$538.32	$817.90	$1,184.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $72.37 / $401.10 / $647.46	Professional		$72.37	$401.10	$647.46
United Facility/Professional Facility Modifier Low / Median / High Price $2,840.00 / $5,998.00 / $9,524.00	Facility		$2,840.00	$5,998.00	$9,524.00
United Facility/Professional Professional Modifier Low / Median / High Price $480.66 / $743.99 / $1,163.21	Professional		$480.66	$743.99	$1,163.21