Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $226.68 / $1,593.00 / $4,642.34	Facility		$226.68	$1,593.00	$4,642.34
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $972.46 / $2,535.98 / $6,078.04	Facility	50	$972.46	$2,535.98	$6,078.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.01 / $170.56 / $362.98	Professional		$53.01	$170.56	$362.98
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $81.45 / $148.28 / $494.55	Professional	50	$81.45	$148.28	$494.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.78 / $58.46 / $210.09	Professional		$51.78	$58.46	$210.09
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $74.70 / $87.69 / $315.13	Professional	50	$74.70	$87.69	$315.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $2,059.00 / $2,412.00	Facility		$937.00	$2,059.00	$2,412.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.98 / $68.62 / $122.04	Professional		$51.98	$68.62	$122.04
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $77.97 / $102.74 / $183.06	Professional	50	$77.97	$102.74	$183.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $55.68 / $66.81 / $83.52	Facility		$55.68	$66.81	$83.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $220.49 / $273.12 / $425.43	Professional		$220.49	$273.12	$425.43
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 $65.76 / $130.78 / $341.84	Professional		$65.76	$130.78	$341.84
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $444.09 / $965.65 / $2,079.65	Facility		$444.09	$965.65	$2,079.65
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $66.25 / $128.06 / $346.64	Professional		$66.25	$128.06	$346.64
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $57.26 / $92.46 / $92.46	Professional	50	$57.26	$92.46	$92.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $180.41 / $241.03 / $345.58	Professional		$180.41	$241.03	$345.58
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 $140.84 / $225.27 / $334.60	Professional		$140.84	$225.27	$334.60