Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $1,412.54 / $7,079.46	Facility		$125.89	$1,412.54	$7,079.46
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,584.89 / $1,584.89 / $2,137.96	Facility	50	$1,584.89	$1,584.89	$2,137.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $134.90 / $295.12	Professional		$64.57	$134.90	$295.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $208.93 / $208.93 / $208.93	Professional	50	$208.93	$208.93	$208.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $69.18 / $91.20	Professional		$64.57	$69.18	$91.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,238.72 / $3,981.07	Facility		$707.95	$2,238.72	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $83.18 / $138.04	Professional		$61.66	$83.18	$138.04
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $93.33 / $125.89 / $208.93	Professional	50	$93.33	$125.89	$208.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $89.13 / $117.49	Facility		$67.61	$89.13	$117.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $194.98 / $331.13	Professional		$147.91	$194.98	$331.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $151.36 / $21,379.62	Facility		$87.10	$151.36	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $141.25 / $251.19	Professional		$70.79	$141.25	$251.19
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $1,412.54 / $2,951.21	Facility		$436.52	$1,412.54	$2,951.21
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $131.83 / $251.19	Professional		$70.79	$131.83	$251.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $33.11 / $33.11	Professional		$30.20	$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 $67.61 / $165.96 / $257.04	Professional		$67.61	$165.96	$257.04
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 $50.12 / $104.71 / $204.17	Professional		$50.12	$104.71	$204.17