Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $96.28 / $980.44 / $3,116.00	Facility		$96.28	$980.44	$3,116.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $476.14 / $784.48 / $1,725.75	Facility	50	$476.14	$784.48	$1,725.75
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $9.16 / $21.18 / $62.04	Facility	53	$9.16	$21.18	$62.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.07 / $96.28 / $222.98	Professional		$46.07	$96.28	$222.98
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $69.93 / $143.31 / $204.41	Professional	50	$69.93	$143.31	$204.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.69 / $62.00 / $99.85	Professional		$47.69	$62.00	$99.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $711.00 / $2,059.00 / $2,550.00	Facility		$711.00	$2,059.00	$2,550.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.91 / $64.70 / $111.73	Professional		$48.91	$64.70	$111.73
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $73.37 / $97.06 / $167.60	Professional	50	$73.37	$97.06	$167.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.69 / $57.23 / $71.54	Facility		$47.69	$57.23	$71.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $104.17 / $129.81 / $202.20	Professional		$104.17	$129.81	$202.20
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 $57.23 / $102.43 / $182.96	Professional		$57.23	$102.43	$182.96
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $375.48 / $841.18 / $1,171.82	Facility		$375.48	$841.18	$1,171.82
Medical Mutual of Ohio Facility/Professional Facility Modifier 53 Low / Median / High Price $17.26 / $17.26 / $17.26	Facility	53	$17.26	$17.26	$17.26
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $57.28 / $102.43 / $189.71	Professional		$57.28	$102.43	$189.71
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $104.14 / $104.14 / $178.47	Professional	50	$104.14	$104.14	$178.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.45 / $104.97 / $150.61	Professional		$79.45	$104.97	$150.61
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $965.00 / $2,914.00	Facility		$444.00	$965.00	$2,914.00
United Facility/Professional Professional Modifier Low / Median / High Price $85.46 / $142.66 / $222.74	Professional		$85.46	$142.66	$222.74