Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $160.35 / $1,518.50 / $6,870.70	Facility		$160.35	$1,518.50	$6,870.70
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,203.90 / $2,203.90 / $2,203.90	Facility	50	$2,203.90	$2,203.90	$2,203.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.43 / $113.14 / $214.63	Professional		$60.43	$113.14	$214.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,981.00 / $3,943.00	Facility		$937.00	$1,981.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.92 / $84.74 / $163.32	Professional		$49.92	$84.74	$163.32
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $74.88 / $127.11 / $244.98	Professional	50	$74.88	$127.11	$244.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $66.12 / $79.34 / $99.18	Facility		$66.12	$79.34	$99.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $126.99 / $159.13 / $247.88	Professional		$126.99	$159.13	$247.88
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 $76.04 / $120.58 / $208.38	Professional		$76.04	$120.58	$208.38
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $333.60 / $1,791.69 / $6,140.32	Facility		$333.60	$1,791.69	$6,140.32
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $77.37 / $119.96 / $211.37	Professional		$77.37	$119.96	$211.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $105.96 / $142.18 / $202.87	Professional		$105.96	$142.18	$202.87
United Facility/Professional Facility Modifier Low / Median / High Price $1,020.00 / $1,940.00 / $4,067.00	Facility		$1,020.00	$1,940.00	$4,067.00
United Facility/Professional Professional Modifier Low / Median / High Price $92.97 / $150.96 / $230.99	Professional		$92.97	$150.96	$230.99