Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.06 / $2,113.00 / $10,268.00	Facility		$142.06	$2,113.00	$10,268.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,567.68 / $6,242.74 / $6,524.56	Facility	50	$1,567.68	$6,242.74	$6,524.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.58 / $142.06 / $286.06	Professional		$96.58	$142.06	$286.06
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 $94.21 / $122.47 / $196.70	Professional		$94.21	$122.47	$196.70
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $141.32 / $183.71 / $295.06	Professional	50	$141.32	$183.71	$295.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $95.96 / $123.17 / $163.59	Facility		$95.96	$123.17	$163.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $164.12 / $208.88 / $127,498.73	Professional		$164.12	$208.88	$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 $120.09 / $186.50 / $317.74	Professional		$120.09	$186.50	$317.74
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $184.66 / $184.66 / $1,794.56	Facility		$184.66	$184.66	$1,794.56
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $122.14 / $184.75 / $314.50	Professional		$122.14	$184.75	$314.50
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $965.18 / $965.18 / $965.18	Professional	50	$965.18	$965.18	$965.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $120.45 / $159.84 / $226.80	Professional		$120.45	$159.84	$226.80
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 $138.68 / $218.60 / $319.72	Professional		$138.68	$218.60	$319.72