Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.60 / $1,297.50 / $4,697.18	Facility		$91.60	$1,297.50	$4,697.18
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $573.08 / $4,350.32 / $6,524.56	Facility	50	$573.08	$4,350.32	$6,524.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.36 / $73.73 / $178.80	Professional		$39.36	$73.73	$178.80
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $57.98 / $242.15 / $502.50	Professional	50	$57.98	$242.15	$502.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.57 / $79.52 / $93.55	Professional		$54.57	$79.52	$93.55
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 $41.50 / $66.91 / $113.74	Professional		$41.50	$66.91	$113.74
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $62.25 / $100.36 / $170.62	Professional	50	$62.25	$100.36	$170.62
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $81.42 / $81.42 / $81.42	Professional		$81.42	$81.42	$81.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $38.97 / $46.78 / $58.47	Facility		$38.97	$46.78	$58.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.47 / $88.21 / $137.40	Professional		$70.47	$88.21	$137.40
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 $46.82 / $84.82 / $147.74	Professional		$46.82	$84.82	$147.74
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $344.07 / $1,348.75 / $3,022.10	Facility		$344.07	$1,348.75	$3,022.10
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $83.60 / $150.35	Professional		$46.77	$83.60	$150.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $53.47 / $71.09 / $101.43	Professional		$53.47	$71.09	$101.43
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 $64.53 / $101.62 / $155.49	Professional		$64.53	$101.62	$155.49