Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.58 / $4,853.53 / $10,721.00	Facility		$115.58	$4,853.53	$10,721.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,443.06 / $8,510.46 / $10,461.50	Facility	50	$2,443.06	$8,510.46	$10,461.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $100.38 / $188.55	Professional		$56.23	$100.38	$188.55
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $154.02 / $199.97 / $199.97	Professional	50	$154.02	$199.97	$199.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $814.00 / $1,927.00 / $3,943.00	Facility		$814.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.81 / $76.33 / $122.91	Professional		$56.81	$76.33	$122.91
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $85.22 / $114.82 / $184.37	Professional	50	$85.22	$114.82	$184.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $60.36 / $72.43 / $90.54	Facility		$60.36	$72.43	$90.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $110.60 / $139.00 / $216.51	Professional		$110.60	$139.00	$216.51
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 $69.41 / $111.81 / $192.45	Professional		$69.41	$111.81	$192.45
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $330.12 / $1,982.31 / $7,206.96	Facility		$330.12	$1,982.31	$7,206.96
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $66.40 / $108.65 / $187.11	Professional		$66.40	$108.65	$187.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.46 / $104.97 / $150.61	Professional		$78.46	$104.97	$150.61
United Facility/Professional Facility Modifier Low / Median / High Price $1,020.00 / $1,940.00 / $5,437.00	Facility		$1,020.00	$1,940.00	$5,437.00
United Facility/Professional Professional Modifier Low / Median / High Price $69.43 / $115.41 / $200.74	Professional		$69.43	$115.41	$200.74