Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $170.62 / $1,607.00 / $3,939.60	Facility		$170.62	$1,607.00	$3,939.60
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $579.16 / $2,951.60 / $8,119.08	Facility	50	$579.16	$2,951.60	$8,119.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.24 / $167.95 / $323.12	Professional		$93.24	$167.95	$323.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $153.22 / $313.83 / $895.00	Professional	50	$153.22	$313.83	$895.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $99.03 / $118.83 / $175.64	Professional		$99.03	$118.83	$175.64
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $178.25 / $178.25 / $178.25	Professional	50	$178.25	$178.25	$178.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $814.00 / $1,981.00 / $3,943.00	Facility		$814.00	$1,981.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.65 / $122.96 / $202.62	Professional		$93.65	$122.96	$202.62
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $140.47 / $184.44 / $303.93	Professional	50	$140.47	$184.44	$303.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $99.03 / $118.84 / $148.55	Facility		$99.03	$118.84	$148.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $182.67 / $228.33 / $355.67	Professional		$182.67	$228.33	$355.67
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 $115.86 / $197.80 / $331.89	Professional		$115.86	$197.80	$331.89
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $554.79 / $1,023.48 / $2,364.61	Facility		$554.79	$1,023.48	$2,364.61
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $115.76 / $200.27 / $333.72	Professional		$115.76	$200.27	$333.72
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $236.07 / $243.38 / $393.60	Professional	50	$236.07	$243.38	$393.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $156.93 / $211.46 / $301.23	Professional		$156.93	$211.46	$301.23
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 $161.32 / $252.18 / $387.74	Professional		$161.32	$252.18	$387.74