Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $473.88 / $6,064.00 / $11,581.00	Facility		$473.88	$6,064.00	$11,581.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,107.01 / $5,647.17 / $12,380.20	Facility	50	$2,107.01	$5,647.17	$12,380.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.68 / $367.08 / $692.40	Professional		$318.68	$367.08	$692.40
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $867.69 / $1,075.81 / $2,795.80	Professional	50	$867.69	$1,075.81	$2,795.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,895.00 / $5,563.00 / $29,406.00	Facility		$1,895.00	$5,563.00	$29,406.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $348.74 / $478.92 / $875.14	Professional		$348.74	$478.92	$875.14
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $523.11 / $718.38 / $1,299.30	Professional	50	$523.11	$718.38	$1,299.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $304.45 / $365.34 / $570.84	Facility		$304.45	$365.34	$570.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $334.90 / $467.49 / $593.69	Professional		$334.90	$467.49	$593.69
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 $307.49 / $478.93 / $760.83	Professional		$307.49	$478.93	$760.83
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,205.31 / $2,594.59 / $4,482.68	Facility		$2,205.31	$2,594.59	$4,482.68
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $319.67 / $482.59 / $760.83	Professional		$319.67	$482.59	$760.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $299.99 / $398.26 / $531.79	Professional		$299.99	$398.26	$531.79
United Facility/Professional Facility Modifier Low / Median / High Price $2,874.00 / $6,111.00 / $7,853.00	Facility		$2,874.00	$6,111.00	$7,853.00
United Facility/Professional Professional Modifier Low / Median / High Price $312.47 / $431.83 / $704.48	Professional		$312.47	$431.83	$704.48