Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $126.80 / $2,021.00 / $9,516.00	Facility		$126.80	$2,021.00	$9,516.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $922.76 / $922.76 / $922.76	Facility	50	$922.76	$922.76	$922.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.02 / $179.40 / $323.79	Professional		$73.02	$179.40	$323.79
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $119.06 / $630.38 / $630.38	Professional	50	$119.06	$630.38	$630.38
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 $70.81 / $92.06 / $147.25	Professional		$70.81	$92.06	$147.25
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $106.23 / $138.10 / $220.87	Professional	50	$106.23	$138.10	$220.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $72.70 / $93.30 / $123.92	Facility		$72.70	$93.30	$123.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $217.46 / $276.77 / $127,498.73	Professional		$217.46	$276.77	$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 $89.99 / $172.13 / $353.20	Professional		$89.99	$172.13	$353.20
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $296.44 / $1,179.80 / $2,255.57	Facility		$296.44	$1,179.80	$2,255.57
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $112.30 / $112.30 / $112.30	Facility	52	$112.30	$112.30	$112.30
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $90.97 / $172.13 / $355.84	Professional		$90.97	$172.13	$355.84
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 $174.22 / $267.95 / $389.82	Professional		$174.22	$267.95	$389.82