Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $2,398.83 / $10,000.00	Facility		$426.58	$2,398.83	$10,000.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,584.89 / $3,162.28 / $15,848.93	Facility	50	$1,584.89	$3,162.28	$15,848.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $208.93 / $467.74	Professional		$125.89	$208.93	$467.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $144.54 / $218.78	Professional		$120.23	$144.54	$218.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $162.18 / $269.15	Professional		$125.89	$162.18	$269.15
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Professional		$245.47	$245.47	$245.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $158.49 / $181.97	Facility		$131.83	$158.49	$181.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $177.83 / $323.59	Professional		$158.49	$177.83	$323.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $213.80 / $21,379.62	Facility		$112.20	$213.80	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $186.21 / $295.12	Professional		$141.25	$186.21	$295.12
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $0.72 / $3,235.94 / $8,128.31	Facility		$0.72	$3,235.94	$8,128.31
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $194.98 / $302.00	Professional		$134.90	$194.98	$302.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $169.82 / $281.84	Professional		$131.83	$169.82	$281.84
United Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $954.99 / $3,019.95	Facility		$457.09	$954.99	$3,019.95
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $169.82 / $281.84	Professional		$123.03	$169.82	$281.84