Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $2,238.72 / $8,912.51	Facility		$302.00	$2,238.72	$8,912.51
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $977.24 / $3,801.89 / $8,317.64	Facility	50	$977.24	$3,801.89	$8,317.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $331.13 / $1,288.25	Professional		$173.78	$331.13	$1,288.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.86 / $295.12 / $2,398.83	Professional	50	$47.86	$295.12	$2,398.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $154.88 / $190.55	Professional		$85.11	$154.88	$190.55
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $97.72 / $151.36 / $446.68	Professional	50	$97.72	$151.36	$446.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $3,019.95 / $7,943.28	Facility		$1,000.00	$3,019.95	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $371.54 / $630.96	Professional		$208.93	$371.54	$630.96
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $309.03 / $549.54 / $912.01	Professional	50	$309.03	$549.54	$912.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $204.17 / $234.42	Facility		$169.82	$204.17	$234.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $371.54 / $645.65	Professional		$323.59	$371.54	$645.65
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 $199.53 / $331.13 / $630.96	Professional		$199.53	$331.13	$630.96
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $1,202.26 / $2,454.71	Facility		$323.59	$1,202.26	$2,454.71
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $331.13 / $630.96	Professional		$194.98	$331.13	$630.96
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $158.49 / $177.83 / $295.12	Professional	50	$158.49	$177.83	$295.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $169.82	Professional		$32.36	$33.11	$169.82
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $4,073.80	Facility		$100.00	$100.00	$4,073.80
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $309.03 / $588.84	Professional		$165.96	$309.03	$588.84
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $4,365.16 / $7,413.10	Facility		$2,454.71	$4,365.16	$7,413.10
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $309.03 / $549.54	Professional		$173.78	$309.03	$549.54