Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $496.81 / $3,027.00 / $9,516.00	Facility		$496.81	$3,027.00	$9,516.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $21,809.14 / $21,809.14 / $21,809.14	Facility	50	$21,809.14	$21,809.14	$21,809.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.60 / $496.81 / $828.02	Professional		$177.60	$496.81	$828.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $438.75 / $438.75 / $438.75	Professional	50	$438.75	$438.75	$438.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,760.00 / $3,528.00 / $14,996.00	Facility		$1,760.00	$3,528.00	$14,996.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $176.12 / $404.84 / $726.34	Professional		$176.12	$404.84	$726.34
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $264.18 / $607.26 / $1,086.44	Professional	50	$264.18	$607.26	$1,086.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $170.41 / $204.49 / $319.52	Facility		$170.41	$204.49	$319.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $507.39 / $567.11 / $899.46	Professional		$507.39	$567.11	$899.46
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 $204.49 / $499.53 / $914.40	Professional		$204.49	$499.53	$914.40
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $4,634.35 / $4,634.35 / $4,895.87	Facility		$4,634.35	$4,634.35	$4,895.87
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $211.25 / $501.16 / $915.69	Professional		$211.25	$501.16	$915.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $427.16 / $579.77 / $791.81	Professional		$427.16	$579.77	$791.81
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 $443.82 / $639.22 / $1,068.15	Professional		$443.82	$639.22	$1,068.15