Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.85 / $729.44 / $3,335.12	Facility		$89.85	$729.44	$3,335.12
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $465.02 / $848.19 / $1,908.20	Facility	50	$465.02	$848.19	$1,908.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.71 / $91.37 / $169.90	Professional		$52.71	$91.37	$169.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $86.31 / $146.91 / $452.01	Professional	50	$86.31	$146.91	$452.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.30 / $67.56 / $90.19	Professional		$56.30	$67.56	$90.19
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $101.35 / $101.35 / $101.35	Professional	50	$101.35	$101.35	$101.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $2,059.00 / $2,412.00	Facility		$937.00	$2,059.00	$2,412.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.91 / $70.37 / $114.80	Professional		$52.91	$70.37	$114.80
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $79.37 / $105.56 / $172.21	Professional	50	$79.37	$105.56	$172.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $56.30 / $67.56 / $84.45	Facility		$56.30	$67.56	$84.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $92.89 / $117.25 / $183.03	Professional		$92.89	$117.25	$183.03
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 $66.12 / $104.65 / $168.65	Professional		$66.12	$104.65	$168.65
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $396.10 / $781.61 / $1,363.73	Facility		$396.10	$781.61	$1,363.73
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $66.12 / $106.98 / $171.37	Professional		$66.12	$106.98	$171.37
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $89.68 / $91.70 / $133.52	Professional	50	$89.68	$91.70	$133.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.46 / $105.73 / $150.61	Professional		$78.46	$105.73	$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 $78.53 / $124.83 / $186.05	Professional		$78.53	$124.83	$186.05