Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.52 / $1,883.00 / $9,504.00	Facility		$117.52	$1,883.00	$9,504.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $772.60 / $772.60 / $772.60	Facility	50	$772.60	$772.60	$772.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.81 / $117.52 / $232.13	Professional		$69.81	$117.52	$232.13
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $195.26 / $195.26 / $195.26	Professional	50	$195.26	$195.26	$195.26
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 $88.26 / $145.35 / $238.22	Professional		$88.26	$145.35	$238.22
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $132.38 / $218.02 / $357.34	Professional	50	$132.38	$218.02	$357.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $68.95 / $88.49 / $117.53	Facility		$68.95	$88.49	$117.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $134.93 / $171.72 / $127,498.73	Professional		$134.93	$171.72	$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 $87.75 / $147.19 / $249.34	Professional		$87.75	$147.19	$249.34
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $133.72 / $133.72 / $2,180.98	Facility		$133.72	$133.72	$2,180.98
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $87.75 / $145.96 / $249.34	Professional		$87.75	$145.96	$249.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.37 / $144.50 / $202.94	Professional		$109.37	$144.50	$202.94
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 $112.95 / $175.47 / $267.27	Professional		$112.95	$175.47	$267.27