Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.19 / $951.00 / $3,847.00	Facility		$87.19	$951.00	$3,847.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $473.50 / $932.80 / $2,502.82	Facility	50	$473.50	$932.80	$2,502.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.23 / $79.26 / $170.69	Professional		$45.23	$79.26	$170.69
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $73.41 / $148.51 / $408.83	Professional	50	$73.41	$148.51	$408.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.48 / $62.48 / $62.48	Professional		$62.48	$62.48	$62.48
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $72.09 / $75.70 / $125.14	Professional	50	$72.09	$75.70	$125.14
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 $45.39 / $60.07 / $99.06	Professional		$45.39	$60.07	$99.06
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $68.09 / $90.11 / $148.59	Professional	50	$68.09	$90.11	$148.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $48.06 / $57.67 / $72.09	Facility		$48.06	$57.67	$72.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $86.34 / $108.46 / $168.95	Professional		$86.34	$108.46	$168.95
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 $56.92 / $94.01 / $155.13	Professional		$56.92	$94.01	$155.13
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $292.01 / $628.97 / $1,782.85	Facility		$292.01	$628.97	$1,782.85
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $56.24 / $94.01 / $157.34	Professional		$56.24	$94.01	$157.34
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $48.99 / $49.35 / $478.40	Professional	50	$48.99	$49.35	$478.40
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 $73.05 / $115.43 / $173.84	Professional		$73.05	$115.43	$173.84