Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $4,570.88 / $10,964.78	Facility		$239.88	$4,570.88	$10,964.78
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,258.93 / $1,258.93 / $1,584.89	Facility	50	$1,258.93	$1,258.93	$1,584.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $1,513.56 / $3,890.45	Professional		$141.25	$1,513.56	$3,890.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $4,168.69 / $15,135.61	Facility		$1,949.84	$4,168.69	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $1,445.44 / $5,754.40	Professional		$162.18	$1,445.44	$5,754.40
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $245.47 / $2,137.96 / $8,511.38	Professional	50	$245.47	$2,137.96	$8,511.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $144.54 / $162.18	Facility		$134.90	$144.54	$162.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $1,412.54 / $21,379.62	Facility		$120.23	$1,412.54	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $407.38 / $3,311.31	Professional		$162.18	$407.38	$3,311.31
Medical Mutual of Ohio 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
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $407.38 / $3,467.37	Professional		$165.96	$407.38	$3,467.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $134.90	Professional		$32.36	$33.11	$134.90
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $8,709.64	Facility		$100.00	$100.00	$8,709.64
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $1,513.56 / $3,467.37	Professional		$125.89	$1,513.56	$3,467.37
United Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $4,466.84 / $7,413.10	Facility		$2,570.40	$4,466.84	$7,413.10
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $1,258.93 / $3,890.45	Professional		$144.54	$1,258.93	$3,890.45