Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $1,949.84 / $4,677.35	Facility		$204.17	$1,949.84	$4,677.35
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,348.96 / $2,754.23 / $3,715.35	Facility	50	$1,348.96	$2,754.23	$3,715.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $134.90 / $380.19	Professional		$70.79	$134.90	$380.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $79.43 / $162.18	Professional		$66.07	$79.43	$162.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $2,754.23 / $7,943.28	Facility		$1,000.00	$2,754.23	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $120.23 / $218.78	Professional		$72.44	$120.23	$218.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $95.50 / $112.20	Facility		$79.43	$95.50	$112.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $213.80 / $363.08	Professional		$186.21	$213.80	$363.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $147.91 / $21,379.62	Facility		$112.20	$147.91	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $147.91 / $257.04	Professional		$89.13	$147.91	$257.04
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,318.26 / $2,951.21	Facility		$891.25	$1,318.26	$2,951.21
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $151.36 / $263.03	Professional		$87.10	$151.36	$263.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $40.74	Professional		$32.36	$33.11	$40.74
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $2,041.74	Facility		$100.00	$100.00	$2,041.74
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $169.82 / $275.42	Professional		$77.62	$169.82	$275.42
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $2,570.40 / $5,248.07	Facility		$1,698.24	$2,570.40	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $117.49 / $208.93	Professional		$67.61	$117.49	$208.93