Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $1,819.70 / $4,786.30	Facility		$323.59	$1,819.70	$4,786.30
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,495.41 / $5,495.41 / $5,495.41	Facility	50	$5,495.41	$5,495.41	$5,495.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $213.80 / $660.69	Professional		$104.71	$213.80	$660.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $112.20 / $199.53	Professional		$87.10	$112.20	$199.53
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,137.96 / $3,981.07	Facility		$707.95	$2,137.96	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $302.00 / $776.25	Professional		$102.33	$302.00	$776.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $123.03 / $141.25	Facility		$102.33	$123.03	$141.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $371.54 / $645.65	Professional		$331.13	$371.54	$645.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $269.15 / $21,379.62	Facility		$93.33	$269.15	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $239.88 / $602.56	Professional		$123.03	$239.88	$602.56
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $1,412.54 / $3,630.78	Facility		$467.74	$1,412.54	$3,630.78
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $257.04 / $602.56	Professional		$123.03	$257.04	$602.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $66.07	Professional		$32.36	$33.11	$66.07
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $776.25	Facility		$100.00	$100.00	$776.25
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $309.03 / $707.95	Professional		$97.72	$309.03	$707.95
United Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,862.09 / $4,073.80	Facility		$954.99	$1,862.09	$4,073.80
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $245.47 / $691.83	Professional		$109.65	$245.47	$691.83