Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $8,912.51 / $14,791.08	Facility		$1,047.13	$8,912.51	$14,791.08
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $7,079.46 / $14,791.08 / $15,135.61	Facility	50	$7,079.46	$14,791.08	$15,135.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $891.25 / $2,290.87	Professional		$575.44	$891.25	$2,290.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $524.81 / $645.65	Professional		$489.78	$524.81	$645.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $7,585.78 / $15,135.61	Facility		$1,698.24	$7,585.78	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $812.83 / $1,412.54	Professional		$512.86	$812.83	$1,412.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $645.65 / $758.58	Facility		$537.03	$645.65	$758.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $933.25 / $1,621.81	Professional		$831.76	$933.25	$1,621.81
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 $489.78 / $831.76 / $1,318.26	Professional		$489.78	$831.76	$1,318.26
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $6,760.83 / $12,882.50	Facility		$3,715.35	$6,760.83	$12,882.50
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $831.76 / $1,318.26	Professional		$489.78	$831.76	$1,318.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $323.59	Professional		$32.36	$33.11	$323.59
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $4,365.16	Facility		$100.00	$100.00	$4,365.16
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $794.33 / $1,348.96	Professional		$562.34	$794.33	$1,348.96
United Facility/Professional Facility Modifier Low / Median / High Price $4,073.80 / $9,120.11 / $14,125.38	Facility		$4,073.80	$9,120.11	$14,125.38
United Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $794.33 / $1,288.25	Professional		$537.03	$794.33	$1,288.25