Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.26 / $1,902.00 / $9,504.00	Facility		$131.26	$1,902.00	$9,504.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $962.30 / $1,308.59 / $1,308.59	Facility	50	$962.30	$1,308.59	$1,308.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.17 / $119.73 / $212.30	Professional		$82.17	$119.73	$212.30
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $256.19 / $256.19 / $257.07	Professional	50	$256.19	$256.19	$257.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $814.00 / $1,927.00 / $3,943.00	Facility		$814.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.63 / $87.91 / $154.55	Professional		$60.63	$87.91	$154.55
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $90.94 / $131.87 / $231.82	Professional	50	$90.94	$131.87	$231.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $93.54 / $120.06 / $159.44	Facility		$93.54	$120.06	$159.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $148.30 / $188.75 / $127,498.73	Professional		$148.30	$188.75	$127,498.73
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 $105.47 / $149.44 / $235.19	Professional		$105.47	$149.44	$235.19
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $178.35 / $304.20 / $606.23	Facility		$178.35	$304.20	$606.23
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $106.31 / $155.04 / $242.61	Professional		$106.31	$155.04	$242.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $103.95 / $139.76 / $199.39	Professional		$103.95	$139.76	$199.39
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 $94.56 / $145.47 / $243.26	Professional		$94.56	$145.47	$243.26