Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $211.45 / $1,708.00 / $8,324.64	Facility		$211.45	$1,708.00	$8,324.64
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,464.30 / $3,550.08 / $4,555.50	Facility	50	$2,464.30	$3,550.08	$4,555.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.55 / $229.66 / $436.79	Professional		$115.55	$229.66	$436.79
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $171.84 / $288.25 / $1,332.00	Professional	50	$171.84	$288.25	$1,332.00
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $184.40 / $184.40 / $184.40	Professional	50	$184.40	$184.40	$184.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,051.00 / $2,012.00 / $3,943.00	Facility		$1,051.00	$2,012.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.54 / $128.19 / $216.88	Professional		$92.54	$128.19	$216.88
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $138.82 / $193.25 / $325.32	Professional	50	$138.82	$193.25	$325.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $114.94 / $147.52 / $182.58	Facility		$114.94	$147.52	$182.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $264.89 / $337.13 / $127,498.73	Professional		$264.89	$337.13	$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 $141.37 / $239.50 / $420.90	Professional		$141.37	$239.50	$420.90
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $705.19 / $1,414.95 / $1,680.75	Facility		$705.19	$1,414.95	$1,680.75
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $143.19 / $242.59 / $423.14	Professional		$143.19	$242.59	$423.14
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $187.16 / $302.18 / $302.18	Professional	50	$187.16	$302.18	$302.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $182.42 / $244.92 / $349.85	Professional		$182.42	$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 $209.61 / $332.04 / $494.97	Professional		$209.61	$332.04	$494.97