Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $133.12 / $1,291.75 / $8,956.00	Facility		$133.12	$1,291.75	$8,956.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $624.67 / $1,547.24 / $2,794.71	Facility	50	$624.67	$1,547.24	$2,794.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.40 / $154.76 / $272.49	Professional		$105.40	$154.76	$272.49
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $220.04 / $387.00 / $901.50	Professional	50	$220.04	$387.00	$901.50
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $200.80 / $200.80 / $200.80	Professional	50	$200.80	$200.80	$200.80
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 $96.81 / $131.47 / $208.29	Professional		$96.81	$131.47	$208.29
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $145.21 / $196.86 / $312.44	Professional	50	$145.21	$196.86	$312.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $111.29 / $133.55 / $166.94	Facility		$111.29	$133.55	$166.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $129.38 / $165.74 / $260.45	Professional		$129.38	$165.74	$260.45
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 $123.23 / $178.32 / $269.55	Professional		$123.23	$178.32	$269.55
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $177.16 / $377.36 / $933.47	Facility		$177.16	$377.36	$933.47
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $125.56 / $178.49 / $270.52	Professional		$125.56	$178.49	$270.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $106.00 / $150.61	Professional		$81.79	$106.00	$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 $111.98 / $178.46 / $267.38	Professional		$111.98	$178.46	$267.38