Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $741.60 / $5,563.57 / $9,534.00	Facility		$741.60	$5,563.57	$9,534.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,870.51 / $6,792.66 / $9,831.00	Facility	50	$5,870.51	$6,792.66	$9,831.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $347.81 / $1,186.74 / $3,314.46	Professional		$347.81	$1,186.74	$3,314.46
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $234.47 / $914.40 / $1,758.00	Professional	50	$234.47	$914.40	$1,758.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.03 / $270.06 / $497.48	Professional		$162.03	$270.06	$497.48
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $240.96 / $365.88 / $1,118.02	Professional	50	$240.96	$365.88	$1,118.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,084.00 / $4,918.00 / $19,117.00	Facility		$2,084.00	$4,918.00	$19,117.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $330.54 / $1,265.35 / $2,778.53	Professional		$330.54	$1,265.35	$2,778.53
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $493.51 / $1,898.04 / $4,167.79	Professional	50	$493.51	$1,898.04	$4,167.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $348.46 / $418.15 / $557.67	Facility		$348.46	$418.15	$557.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,758.48 / $2,224.13 / $2,901.49	Professional		$1,758.48	$2,224.13	$2,901.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $621.90 / $621.90 / $21,571.00	Facility		$621.90	$621.90	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $399.10 / $1,084.51 / $3,308.05	Professional		$399.10	$1,084.51	$3,308.05
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,735.72 / $4,367.81 / $15,498.69	Facility		$1,735.72	$4,367.81	$15,498.69
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $383.30 / $749.95 / $3,173.80	Professional		$383.30	$749.95	$3,173.80
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $394.61 / $394.61 / $394.61	Professional	50	$394.61	$394.61	$394.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,591.68 / $2,124.88 / $2,960.47	Professional		$1,591.68	$2,124.88	$2,960.47
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 $1,823.54 / $2,531.94 / $4,284.70	Professional		$1,823.54	$2,531.94	$4,284.70