Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $972.62 / $5,255.00 / $9,504.00	Facility		$972.62	$5,255.00	$9,504.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,180.50 / $6,569.24 / $7,655.00	Facility	50	$6,180.50	$6,569.24	$7,655.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $349.80 / $448.69 / $772.07	Professional		$349.80	$448.69	$772.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $465.32 / $465.32 / $1,048.04	Professional		$465.32	$465.32	$1,048.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,794.00 / $3,576.00 / $14,996.00	Facility		$1,794.00	$3,576.00	$14,996.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $305.11 / $399.79 / $720.20	Professional		$305.11	$399.79	$720.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $332.37 / $415.46 / $493.66	Facility		$332.37	$415.46	$493.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $365.61 / $432.08 / $778.27	Professional		$365.61	$432.08	$778.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,571.00 / $21,571.00 / $21,571.00	Facility		$21,571.00	$21,571.00	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $332.37 / $502.16 / $717.25	Professional		$332.37	$502.16	$717.25
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,706.44 / $2,723.82 / $4,818.37	Facility		$1,706.44	$2,723.82	$4,818.37
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $344.22 / $510.19 / $697.98	Professional		$344.22	$510.19	$697.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $330.23 / $438.53 / $582.76	Professional		$330.23	$438.53	$582.76
United Facility/Professional Facility Modifier Low / Median / High Price $2,233.00 / $4,383.00 / $6,522.00	Facility		$2,233.00	$4,383.00	$6,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $345.20 / $475.75 / $848.17	Professional		$345.20	$475.75	$848.17