Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $153.40 / $1,243.80 / $3,614.89	Facility		$153.40	$1,243.80	$3,614.89
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $633.94 / $2,682.50 / $5,689.60	Facility	50	$633.94	$2,682.50	$5,689.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.03 / $153.40 / $293.22	Professional		$80.03	$153.40	$293.22
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $128.01 / $271.77 / $825.00	Professional	50	$128.01	$271.77	$825.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $111.09 / $111.09 / $111.09	Professional		$111.09	$111.09	$111.09
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $128.18 / $134.59 / $242.66	Professional	50	$128.18	$134.59	$242.66
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 $79.50 / $104.76 / $180.88	Professional		$79.50	$104.76	$180.88
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $119.26 / $157.13 / $271.32	Professional	50	$119.26	$157.13	$271.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $85.45 / $102.54 / $128.18	Facility		$85.45	$102.54	$128.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $168.24 / $210.31 / $327.60	Professional		$168.24	$210.31	$327.60
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 $99.98 / $178.18 / $291.20	Professional		$99.98	$178.18	$291.20
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $421.67 / $823.61 / $1,725.26	Facility		$421.67	$823.61	$1,725.26
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $97.73 / $178.18 / $296.92	Professional		$97.73	$178.18	$296.92
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $127.52 / $129.12 / $554.40	Professional	50	$127.52	$129.12	$554.40
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 $146.24 / $228.60 / $356.58	Professional		$146.24	$228.60	$356.58