Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $1,479.11 / $6,760.83	Facility		$218.78	$1,479.11	$6,760.83
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $630.96 / $1,258.93 / $6,025.60	Facility	50	$630.96	$1,258.93	$6,025.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $204.17 / $645.65	Professional		$63.10	$204.17	$645.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $194.98 / $229.09 / $724.44	Professional	50	$194.98	$229.09	$724.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $112.20 / $239.88	Professional		$54.95	$112.20	$239.88
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $114.82 / $309.03 / $549.54	Professional	50	$114.82	$309.03	$549.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $2,137.96 / $2,511.89	Facility		$1,905.46	$2,137.96	$2,511.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $81.28 / $138.04	Professional		$60.26	$81.28	$138.04
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $91.20 / $123.03 / $208.93	Professional	50	$91.20	$123.03	$208.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $81.28 / $107.15	Facility		$63.10	$81.28	$107.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $302.00 / $512.86	Professional		$229.09	$302.00	$512.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $309.03 / $21,379.62	Facility		$109.65	$309.03	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $147.91 / $380.19	Professional		$72.44	$147.91	$380.19
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $1,202.26 / $3,548.13	Facility		$446.68	$1,202.26	$3,548.13
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $147.91 / $371.54	Professional		$69.18	$147.91	$371.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $37.15	Professional		$32.36	$33.11	$37.15
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $208.93 / $389.05	Professional		$60.26	$208.93	$389.05
United Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $954.99 / $3,019.95	Facility		$457.09	$954.99	$3,019.95
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $134.90 / $309.03	Professional		$60.26	$134.90	$309.03