Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $110.82 / $411.00 / $3,196.73	Facility		$110.82	$411.00	$3,196.73
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $399.60 / $555.00 / $2,349.76	Facility	50	$399.60	$555.00	$2,349.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.39 / $129.10 / $287.02	Professional		$56.39	$129.10	$287.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $139.31 / $332.53 / $648.53	Professional	50	$139.31	$332.53	$648.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $69.78 / $69.78 / $75.15	Professional		$69.78	$69.78	$75.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,927.00 / $3,943.00	Facility		$937.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.19 / $66.54 / $118.57	Professional		$49.19	$66.54	$118.57
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $71.33 / $99.81 / $177.85	Professional	50	$71.33	$99.81	$177.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $53.68 / $67.09 / $79.72	Facility		$53.68	$67.09	$79.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $155.63 / $183.94 / $319.64	Professional		$155.63	$183.94	$319.64
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 $64.41 / $136.94 / $269.85	Professional		$64.41	$136.94	$269.85
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $122.53 / $234.62 / $680.39	Facility		$122.53	$234.62	$680.39
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $67.09 / $140.32 / $274.01	Professional		$67.09	$140.32	$274.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $112.90 / $153.74 / $209.77	Professional		$112.90	$153.74	$209.77
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $979.00 / $3,218.00	Facility		$444.00	$979.00	$3,218.00
United Facility/Professional Professional Modifier Low / Median / High Price $90.25 / $151.69 / $292.99	Professional		$90.25	$151.69	$292.99