Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $1,122.02 / $4,786.30	Facility		$83.18	$1,122.02	$4,786.30
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,071.52 / $1,230.27 / $3,981.07	Facility	50	$1,071.52	$1,230.27	$3,981.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $70.79 / $169.82	Professional		$30.90	$70.79	$169.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $38.90 / $56.23	Professional		$17.38	$38.90	$56.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,137.96 / $3,981.07	Facility		$707.95	$2,137.96	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $50.12 / $104.71	Professional		$33.11	$50.12	$104.71
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $33.88 / $33.88	Professional		$31.62	$33.88	$33.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $41.69 / $53.70	Facility		$29.51	$41.69	$53.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $93.33 / $123.03	Professional		$74.13	$93.33	$123.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $21,379.62	Facility		$54.95	$54.95	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $61.66 / $151.36	Professional		$33.88	$61.66	$151.36
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $436.52 / $1,047.13	Facility		$69.18	$436.52	$1,047.13
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $60.26 / $138.04	Professional		$33.11	$60.26	$138.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $489.78	Facility		$100.00	$100.00	$489.78
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $74.13 / $154.88	Professional		$29.51	$74.13	$154.88
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $954.99 / $2,951.21	Facility		$316.23	$954.99	$2,951.21
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $58.88 / $134.90	Professional		$33.11	$58.88	$134.90