Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $5,370.32 / $10,964.78	Facility		$100.00	$5,370.32	$10,964.78
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,454.71 / $8,709.64 / $15,848.93	Facility	50	$2,454.71	$8,709.64	$15,848.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $104.71 / $239.88	Professional		$56.23	$104.71	$239.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $60.26 / $199.53 / $338.84	Professional	50	$60.26	$199.53	$338.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $60.26 / $81.28	Professional		$57.54	$60.26	$81.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,137.96 / $3,981.07	Facility		$707.95	$2,137.96	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $81.28 / $125.89	Professional		$58.88	$81.28	$125.89
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $89.13 / $120.23 / $190.55	Professional	50	$89.13	$120.23	$190.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $77.62 / $102.33	Facility		$60.26	$77.62	$102.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $144.54 / $251.19	Professional		$109.65	$144.54	$251.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $109.65 / $190.55	Professional		$66.07	$109.65	$190.55
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $1,479.11 / $6,760.83	Facility		$269.15	$1,479.11	$6,760.83
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $100.00 / $190.55	Professional		$61.66	$100.00	$190.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $32.36 / $33.11	Professional		$26.92	$32.36	$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 $63.10 / $131.83 / $199.53	Professional		$63.10	$131.83	$199.53
United Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,862.09 / $4,168.69	Facility		$954.99	$1,862.09	$4,168.69
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $83.18 / $151.36	Professional		$46.77	$83.18	$151.36