Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $294.70 / $1,883.00 / $9,504.00	Facility		$294.70	$1,883.00	$9,504.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $756.43 / $3,656.50 / $3,656.50	Facility	50	$756.43	$3,656.50	$3,656.50
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $175.65 / $308.24 / $708.29	Facility	54	$175.65	$308.24	$708.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.20 / $307.31 / $707.27	Professional		$234.20	$307.31	$707.27
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $426.38 / $957.38 / $2,704.50	Professional	50	$426.38	$957.38	$2,704.50
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $175.65 / $217.60 / $392.75	Professional	54	$175.65	$217.60	$392.75
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $35.13 / $43.52 / $78.55	Professional	55	$35.13	$43.52	$78.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $215.52 / $269.14 / $376.81	Professional		$215.52	$269.14	$376.81
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $399.56 / $399.56 / $399.56	Professional	50	$399.56	$399.56	$399.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,927.00 / $3,943.00	Facility		$937.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $267.45 / $382.68 / $686.12	Professional		$267.45	$382.68	$686.12
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $401.19 / $574.02 / $1,029.19	Professional	50	$401.19	$574.02	$1,029.19
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $304.14 / $304.14 / $304.14	Professional		$304.14	$304.14	$304.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $216.67 / $280.18 / $343.49	Facility		$216.67	$280.18	$343.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $296.07 / $336.44 / $624.04	Professional		$296.07	$336.44	$624.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $167.08 / $186.31 / $21,571.00	Facility		$167.08	$186.31	$21,571.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $271.12 / $271.12 / $271.12	Facility	54	$271.12	$271.12	$271.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $224.20 / $347.93 / $639.52	Professional		$224.20	$347.93	$639.52
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $167.08 / $992.90 / $1,806.86	Facility		$167.08	$992.90	$1,806.86
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $226.30 / $353.83 / $619.04	Professional		$226.30	$353.83	$619.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.50 / $249.26 / $394.77	Professional		$34.50	$249.26	$394.77
United Facility/Professional Facility Modifier Low / Median / High Price $745.00 / $1,848.00 / $3,923.00	Facility		$745.00	$1,848.00	$3,923.00
United Facility/Professional Professional Modifier Low / Median / High Price $270.60 / $348.80 / $635.11	Professional		$270.60	$348.80	$635.11