Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.18 / $1,967.00 / $9,504.00	Facility		$123.18	$1,967.00	$9,504.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,280.00 / $6,061.88 / $6,061.88	Facility	50	$2,280.00	$6,061.88	$6,061.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.45 / $174.96 / $332.33	Professional		$72.45	$174.96	$332.33
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $176.35 / $220.42 / $298.85	Professional	50	$176.35	$220.42	$298.85
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 $68.84 / $89.59 / $143.76	Professional		$68.84	$89.59	$143.76
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $103.28 / $134.27 / $215.65	Professional	50	$103.28	$134.27	$215.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $72.42 / $92.95 / $123.45	Facility		$72.42	$92.95	$123.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $223.29 / $284.19 / $127,498.73	Professional		$223.29	$284.19	$127,498.73
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 $89.08 / $167.25 / $349.76	Professional		$89.08	$167.25	$349.76
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $139.86 / $139.86 / $139.86	Facility		$139.86	$139.86	$139.86
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $90.63 / $167.25 / $355.23	Professional		$90.63	$167.25	$355.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $184.90 / $244.92 / $349.85	Professional		$184.90	$244.92	$349.85
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 $169.17 / $272.42 / $415.78	Professional		$169.17	$272.42	$415.78