Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $342.75 / $3,027.00 / $9,504.00	Facility		$342.75	$3,027.00	$9,504.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,415.50 / $3,415.50 / $5,900.73	Facility	50	$3,415.50	$3,415.50	$5,900.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $224.49 / $335.81 / $661.54	Professional		$224.49	$335.81	$661.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $315.72 / $315.72 / $315.72	Professional	50	$315.72	$315.72	$315.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $296.14 / $296.14 / $296.14	Professional		$296.14	$296.14	$296.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,145.00 / $2,792.00 / $8,800.00	Facility		$1,145.00	$2,792.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.11 / $267.95 / $454.48	Professional		$160.11	$267.95	$454.48
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $240.17 / $401.94 / $681.72	Professional	50	$240.17	$401.94	$681.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $194.88 / $283.77 / $358.25	Facility		$194.88	$283.77	$358.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $231.29 / $309.67 / $548.97	Professional		$231.29	$309.67	$548.97
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 $215.28 / $317.57 / $550.40	Professional		$215.28	$317.57	$550.40
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $4,086.37 / $4,086.37 / $4,086.37	Facility		$4,086.37	$4,086.37	$4,086.37
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $229.27 / $329.40 / $551.76	Professional		$229.27	$329.40	$551.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $256.88 / $394.52	Professional		$32.36	$256.88	$394.52
United Facility/Professional Facility Modifier Low / Median / High Price $1,771.00 / $2,869.00 / $5,457.00	Facility		$1,771.00	$2,869.00	$5,457.00
United Facility/Professional Professional Modifier Low / Median / High Price $304.19 / $392.63 / $635.75	Professional		$304.19	$392.63	$635.75