Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $202.41 / $2,393.96 / $6,039.50	Facility		$202.41	$2,393.96	$6,039.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.80 / $165.91 / $314.73	Professional		$72.80	$165.91	$314.73
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $106.16 / $439.76 / $1,571.75	Professional	50	$106.16	$439.76	$1,571.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.77 / $77.44 / $158.77	Professional		$63.77	$77.44	$158.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,145.00 / $2,786.00 / $8,800.00	Facility		$1,145.00	$2,786.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.62 / $139.29 / $255.10	Professional		$75.62	$139.29	$255.10
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $113.43 / $208.94 / $382.65	Professional	50	$113.43	$208.94	$382.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $70.08 / $87.60 / $104.08	Facility		$70.08	$87.60	$104.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $174.65 / $206.40 / $357.59	Professional		$174.65	$206.40	$357.59
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 $84.09 / $182.59 / $322.80	Professional		$84.09	$182.59	$322.80
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $957.52 / $2,064.76 / $3,761.17	Facility		$957.52	$2,064.76	$3,761.17
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $87.60 / $190.53 / $322.80	Professional		$87.60	$190.53	$322.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $141.78 / $192.02 / $263.93	Professional		$141.78	$192.02	$263.93
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $2,665.00 / $5,268.00	Facility		$1,689.00	$2,665.00	$5,268.00
United Facility/Professional Professional Modifier Low / Median / High Price $158.11 / $216.72 / $349.77	Professional		$158.11	$216.72	$349.77