Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $446.09 / $3,124.50 / $8,876.00	Facility		$446.09	$3,124.50	$8,876.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,003.80 / $3,999.58 / $6,904.77	Facility	50	$1,003.80	$3,999.58	$6,904.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $261.98 / $319.61 / $582.24	Professional		$261.98	$319.61	$582.24
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $175.06 / $286.58 / $850.27	Professional	50	$175.06	$286.58	$850.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,895.00 / $5,211.00 / $29,406.00	Facility		$1,895.00	$5,211.00	$29,406.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $274.79 / $364.70 / $654.14	Professional		$274.79	$364.70	$654.14
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $412.19 / $547.05 / $972.51	Professional	50	$412.19	$547.05	$972.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $249.80 / $312.25 / $371.02	Facility		$249.80	$312.25	$371.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $274.77 / $324.74 / $584.76	Professional		$274.77	$324.74	$584.76
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 $270.04 / $391.30 / $599.49	Professional		$270.04	$391.30	$599.49
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $551.14 / $1,382.05 / $2,674.57	Facility		$551.14	$1,382.05	$2,674.57
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $274.07 / $398.91 / $599.49	Professional		$274.07	$398.91	$599.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $269.74 / $357.83 / $477.83	Professional		$269.74	$357.83	$477.83
United Facility/Professional Facility Modifier Low / Median / High Price $2,233.00 / $4,383.00 / $6,522.00	Facility		$2,233.00	$4,383.00	$6,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $251.59 / $350.92 / $582.29	Professional		$251.59	$350.92	$582.29