Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.25 / $1,463.50 / $5,925.96	Facility		$138.25	$1,463.50	$5,925.96
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $471.38 / $471.38 / $471.38	Facility	50	$471.38	$471.38	$471.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.06 / $121.44 / $228.77	Professional		$57.06	$121.44	$228.77
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $207.42 / $207.42 / $207.42	Professional	50	$207.42	$207.42	$207.42
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 $57.03 / $77.20 / $131.46	Professional		$57.03	$77.20	$131.46
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $85.54 / $116.10 / $197.19	Professional	50	$85.54	$116.10	$197.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $57.19 / $73.39 / $97.47	Facility		$57.19	$73.39	$97.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $159.97 / $203.60 / $127,498.73	Professional		$159.97	$203.60	$127,498.73
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 $72.78 / $130.88 / $239.53	Professional		$72.78	$130.88	$239.53
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $110.60 / $1,409.51 / $2,899.44	Facility		$110.60	$1,409.51	$2,899.44
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $72.78 / $130.88 / $248.99	Professional		$72.78	$130.88	$248.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $108.45 / $141.63 / $200.06	Professional		$108.45	$141.63	$200.06
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 $111.47 / $171.81 / $258.45	Professional		$111.47	$171.81	$258.45