Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $273.72 / $3,756.24 / $8,956.00	Facility		$273.72	$3,756.24	$8,956.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,431.57 / $7,520.13 / $9,884.64	Facility	50	$1,431.57	$7,520.13	$9,884.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $157.59 / $272.52 / $521.01	Professional		$157.59	$272.52	$521.01
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $414.09 / $749.20 / $795.57	Professional	50	$414.09	$749.20	$795.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,145.00 / $2,792.00 / $8,800.00	Facility		$1,145.00	$2,792.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $152.78 / $250.79 / $468.31	Professional		$152.78	$250.79	$468.31
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $229.18 / $376.18 / $702.47	Professional	50	$229.18	$376.18	$702.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $151.35 / $189.19 / $224.80	Facility		$151.35	$189.19	$224.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $267.95 / $316.67 / $555.26	Professional		$267.95	$316.67	$555.26
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 $181.62 / $288.64 / $498.21	Professional		$181.62	$288.64	$498.21
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $587.75 / $1,682.16 / $3,407.82	Facility		$587.75	$1,682.16	$3,407.82
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $185.92 / $295.00 / $498.21	Professional		$185.92	$295.00	$498.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $228.49 / $310.54 / $419.30	Professional		$228.49	$310.54	$419.30
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $2,665.00 / $5,268.00	Facility		$1,689.00	$2,665.00	$5,268.00
United Facility/Professional Professional Modifier Low / Median / High Price $238.97 / $324.86 / $530.70	Professional		$238.97	$324.86	$530.70