Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $1,778.28 / $8,912.51	Facility		$436.52	$1,778.28	$8,912.51
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $741.31 / $3,467.37 / $3,630.78	Facility	50	$741.31	$3,467.37	$3,630.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $398.11 / $812.83	Professional		$288.40	$398.11	$812.83
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $407.38 / $741.31 / $1,778.28	Professional	50	$407.38	$741.31	$1,778.28
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $245.47 / $323.59 / $912.01	Professional	54	$245.47	$323.59	$912.01
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $63.10 / $63.10 / $389.05	Professional	55	$63.10	$63.10	$389.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $302.00 / $346.74	Professional		$257.04	$302.00	$346.74
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $446.68 / $446.68 / $537.03	Professional	50	$446.68	$446.68	$537.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $2,089.30 / $3,981.07	Facility		$776.25	$2,089.30	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $316.23 / $562.34	Professional		$251.19	$316.23	$562.34
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $380.19 / $478.63 / $831.76	Professional	50	$380.19	$478.63	$831.76
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $338.84 / $524.81	Professional		$323.59	$338.84	$524.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $302.00 / $380.19	Facility		$275.42	$302.00	$380.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $331.13 / $416.87	Professional		$302.00	$331.13	$416.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $302.00 / $21,379.62	Facility		$275.42	$302.00	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $389.05 / $645.65	Professional		$257.04	$389.05	$645.65
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $954.99 / $2,041.74	Facility		$302.00	$954.99	$2,041.74
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $371.54 / $602.56	Professional		$257.04	$371.54	$602.56
Medical Mutual of Ohio Facility/Professional Professional Modifier 54 Low / Median / High Price $407.38 / $407.38 / $407.38	Professional	54	$407.38	$407.38	$407.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $154.88	Professional		$32.36	$33.11	$154.88
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $154.88 / $676.08	Facility		$100.00	$154.88	$676.08
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $354.81 / $630.96	Professional		$275.42	$354.81	$630.96
United Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $1,862.09 / $4,073.80	Facility		$676.08	$1,862.09	$4,073.80
United Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $331.13 / $562.34	Professional		$251.19	$331.13	$562.34