Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $590.11 / $4,437.79 / $11,627.00	Facility		$590.11	$4,437.79	$11,627.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,213.50 / $4,454.02 / $11,412.40	Facility	50	$3,213.50	$4,454.02	$11,412.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $364.61 / $598.11 / $1,057.43	Professional		$364.61	$598.11	$1,057.43
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $630.98 / $630.98 / $630.98	Professional	50	$630.98	$630.98	$630.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,760.00 / $3,528.00 / $14,996.00	Facility		$1,760.00	$3,528.00	$14,996.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $411.90 / $568.97 / $993.44	Professional		$411.90	$568.97	$993.44
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $617.85 / $853.45 / $1,472.78	Professional	50	$617.85	$853.45	$1,472.78
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $511.12 / $511.12 / $511.12	Professional		$511.12	$511.12	$511.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $318.29 / $463.48 / $585.09	Facility		$318.29	$463.48	$585.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $497.55 / $572.20 / $882.03	Professional		$497.55	$572.20	$882.03
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 $354.26 / $627.30 / $1,147.33	Professional		$354.26	$627.30	$1,147.33
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $3,760.86 / $6,861.09 / $8,038.65	Facility		$3,760.86	$6,861.09	$8,038.65
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $354.26 / $632.02 / $1,147.33	Professional		$354.26	$632.02	$1,147.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $67.08 / $421.42 / $634.61	Professional		$67.08	$421.42	$634.61
United Facility/Professional Facility Modifier Low / Median / High Price $2,840.00 / $5,920.00 / $7,847.00	Facility		$2,840.00	$5,920.00	$7,847.00
United Facility/Professional Professional Modifier Low / Median / High Price $508.11 / $762.46 / $1,088.08	Professional		$508.11	$762.46	$1,088.08