Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $1,949.84 / $8,912.51	Facility		$93.33	$1,949.84	$8,912.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $107.15 / $281.84	Professional		$57.54	$107.15	$281.84
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $75.86 / $371.54 / $2,454.71	Professional	50	$75.86	$371.54	$2,454.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $107.15 / $109.65	Professional		$87.10	$107.15	$109.65
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $154.88 / $154.88 / $158.49	Professional	50	$154.88	$154.88	$158.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,995.26 / $3,981.07	Facility		$707.95	$1,995.26	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $70.79 / $112.20	Professional		$53.70	$70.79	$112.20
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $79.43 / $104.71 / $169.82	Professional	50	$79.43	$104.71	$169.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $56.23 / $66.07	Facility		$56.23	$56.23	$66.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $162.18 / $21,379.62	Facility		$77.62	$162.18	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $107.15 / $208.93	Professional		$66.07	$107.15	$208.93
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,513.56 / $21,379.62	Facility		$1,445.44	$1,513.56	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $104.71 / $213.80	Professional		$61.66	$104.71	$213.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $870.96	Facility		$100.00	$100.00	$870.96
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $104.71 / $181.97	Professional		$53.70	$104.71	$181.97
United Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,862.09 / $4,073.80	Facility		$954.99	$1,862.09	$4,073.80
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $93.33 / $190.55	Professional		$52.48	$93.33	$190.55