Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $4,168.69 / $10,715.19	Facility		$724.44	$4,168.69	$10,715.19
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,897.79 / $6,760.83 / $12,589.25	Facility	50	$4,897.79	$6,760.83	$12,589.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $691.83 / $1,819.70	Professional		$295.12	$691.83	$1,819.70
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $676.08 / $1,047.13 / $2,691.53	Professional	50	$676.08	$1,047.13	$2,691.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $302.00 / $549.54	Professional		$223.87	$302.00	$549.54
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $446.68 / $1,096.48 / $2,187.76	Professional	50	$446.68	$1,096.48	$2,187.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $7,413.10 / $30,199.52	Facility		$2,137.96	$7,413.10	$30,199.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $436.52 / $707.95	Professional		$323.59	$436.52	$707.95
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $489.78 / $645.65 / $1,071.52	Professional	50	$489.78	$645.65	$1,071.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $295.12 / $346.74	Facility		$295.12	$295.12	$346.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $645.65 / $1,380.38	Professional		$331.13	$645.65	$1,380.38
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $12,302.69 / $21,379.62	Facility		$5,011.87	$12,302.69	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $645.65 / $1,380.38	Professional		$331.13	$645.65	$1,380.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $144.54	Professional		$32.36	$33.11	$144.54
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $7,762.47	Facility		$100.00	$100.00	$7,762.47
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $691.83 / $1,318.26	Professional		$281.84	$691.83	$1,318.26
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $9,332.54 / $14,791.08	Facility		$4,265.80	$9,332.54	$14,791.08
United Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $588.84 / $1,380.38	Professional		$275.42	$588.84	$1,380.38