Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $581.00 / $2,936.00 / $9,614.94	Facility		$581.00	$2,936.00	$9,614.94
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,072.00 / $5,303.99 / $13,546.04	Facility	50	$3,072.00	$5,303.99	$13,546.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $313.77 / $1,055.70 / $2,546.00	Professional		$313.77	$1,055.70	$2,546.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $343.47 / $803.28 / $2,546.46	Professional	50	$343.47	$803.28	$2,546.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.21 / $288.41 / $406.55	Professional		$144.21	$288.41	$406.55
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $533.61 / $656.73 / $4,075.71	Professional	50	$533.61	$656.73	$4,075.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,009.00 / $3,974.00 / $19,117.00	Facility		$2,009.00	$3,974.00	$19,117.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $299.02 / $1,141.65 / $2,480.75	Professional		$299.02	$1,141.65	$2,480.75
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $448.54 / $1,712.47 / $3,721.12	Professional	50	$448.54	$1,712.47	$3,721.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $318.98 / $464.48 / $498.42	Facility		$318.98	$464.48	$498.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,630.21 / $1,852.51 / $2,889.92	Professional		$1,630.21	$1,852.51	$2,889.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $558.72 / $558.72 / $21,571.00	Facility		$558.72	$558.72	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $359.64 / $964.74 / $2,831.94	Professional		$359.64	$964.74	$2,831.94
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $558.72 / $5,979.09 / $9,886.74	Facility		$558.72	$5,979.09	$9,886.74
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $349.01 / $700.52 / $2,665.98	Professional		$349.01	$700.52	$2,665.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,381.96 / $1,814.23 / $2,512.35	Professional		$1,381.96	$1,814.23	$2,512.35
United Facility/Professional Facility Modifier Low / Median / High Price $4,070.00 / $8,448.00 / $13,382.00	Facility		$4,070.00	$8,448.00	$13,382.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,530.72 / $2,111.64 / $3,552.62	Professional		$1,530.72	$2,111.64	$3,552.62