Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.03 / $758.44 / $8,553.00	Facility		$142.03	$758.44	$8,553.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $667.75 / $667.76 / $2,792.00	Facility	50	$667.75	$667.76	$2,792.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.55 / $177.30 / $366.20	Professional		$83.55	$177.30	$366.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $142.69 / $323.69 / $1,279.50	Professional	50	$142.69	$323.69	$1,279.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,927.00 / $3,943.00	Facility		$937.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.20 / $143.88 / $262.77	Professional		$80.20	$143.88	$262.77
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $120.30 / $215.84 / $393.50	Professional	50	$120.30	$215.84	$393.50
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $203.64 / $203.64 / $203.64	Professional		$203.64	$203.64	$203.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $71.18 / $88.98 / $105.72	Facility		$71.18	$88.98	$105.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $198.23 / $234.27 / $409.14	Professional		$198.23	$234.27	$409.14
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 $81.84 / $187.41 / $308.11	Professional		$81.84	$187.41	$308.11
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $211.34 / $372.36 / $1,004.29	Facility		$211.34	$372.36	$1,004.29
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $85.41 / $188.64 / $311.52	Professional		$85.41	$188.64	$311.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $170.69 / $224.86 / $308.40	Professional		$170.69	$224.86	$308.40
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $979.00 / $3,218.00	Facility		$444.00	$979.00	$3,218.00
United Facility/Professional Professional Modifier Low / Median / High Price $148.91 / $232.00 / $403.48	Professional		$148.91	$232.00	$403.48