Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,001.84 / $4,215.00 / $10,268.00	Facility		$1,001.84	$4,215.00	$10,268.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,758.34 / $19,116.78 / $19,116.78	Facility	50	$2,758.34	$19,116.78	$19,116.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $505.12 / $625.16 / $1,443.93	Professional		$505.12	$625.16	$1,443.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $534.53 / $689.71 / $862.14	Professional		$534.53	$689.71	$862.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,152.00 / $2,792.00 / $8,800.00	Facility		$1,152.00	$2,792.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $429.82 / $594.70 / $950.07	Professional		$429.82	$594.70	$950.07
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $649.48 / $689.71 / $689.71	Professional		$649.48	$689.71	$689.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $574.76 / $689.71 / $862.14	Facility		$574.76	$689.71	$862.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $580.02 / $747.19 / $1,120.79	Professional		$580.02	$747.19	$1,120.79
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 $568.94 / $787.05 / $1,101.30	Professional		$568.94	$787.05	$1,101.30
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $821.85 / $2,601.62 / $4,231.35	Facility		$821.85	$2,601.62	$4,231.35
Medical Mutual of Ohio Facility/Professional Facility Modifier AS Low / Median / High Price $68.64 / $68.64 / $68.64	Facility	AS	$68.64	$68.64	$68.64
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $592.02 / $804.66 / $1,140.22	Professional		$592.02	$804.66	$1,140.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $67.21 / $524.90 / $779.90	Professional		$67.21	$524.90	$779.90
United Facility/Professional Facility Modifier Low / Median / High Price $2,233.00 / $4,223.00 / $6,522.00	Facility		$2,233.00	$4,223.00	$6,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $467.85 / $738.74 / $1,238.47	Professional		$467.85	$738.74	$1,238.47