Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $2,630.27 / $10,715.19	Facility		$331.13	$2,630.27	$10,715.19
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,570.40 / $4,073.80 / $9,772.37	Facility	50	$2,570.40	$4,073.80	$9,772.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $295.12 / $1,288.25	Professional		$97.72	$295.12	$1,288.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $141.25 / $407.38 / $3,467.37	Professional	50	$141.25	$407.38	$3,467.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $93.33 / $162.18	Professional		$79.43	$93.33	$162.18
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $117.49 / $131.83 / $245.47	Professional	50	$117.49	$131.83	$245.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $2,884.03 / $7,943.28	Facility		$1,000.00	$2,884.03	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $489.78 / $851.14	Professional		$112.20	$489.78	$851.14
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $165.96 / $724.44 / $1,258.93	Professional	50	$165.96	$724.44	$1,258.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $100.00 / $112.20	Facility		$93.33	$100.00	$112.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $309.03 / $870.96	Professional		$107.15	$309.03	$870.96
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,862.09 / $3,981.07	Facility		$1,096.48	$1,862.09	$3,981.07
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $323.59 / $851.14	Professional		$109.65	$323.59	$851.14
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 / $2,570.40	Facility		$100.00	$100.00	$2,570.40
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $549.54 / $1,047.13	Professional		$91.20	$549.54	$1,047.13
United Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,862.09 / $4,073.80	Facility		$1,096.48	$1,862.09	$4,073.80
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $363.08 / $851.14	Professional		$100.00	$363.08	$851.14