Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $542.83 / $5,784.00 / $11,561.00	Facility		$542.83	$5,784.00	$11,561.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $493.48 / $594.84 / $988.03	Professional		$493.48	$594.84	$988.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,411.12 / $1,411.12 / $1,460.51	Professional	50	$1,411.12	$1,411.12	$1,460.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $456.15 / $592.99 / $611.77	Professional		$456.15	$592.99	$611.77
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 $480.25 / $602.85 / $1,202.98	Professional		$480.25	$602.85	$1,202.98
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $720.37 / $904.27 / $1,804.48	Professional	50	$720.37	$904.27	$1,804.48
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $531.77 / $531.77 / $531.77	Professional		$531.77	$531.77	$531.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $341.81 / $726.99 / $889.50	Facility		$341.81	$726.99	$889.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $504.05 / $588.24 / $917.66	Professional		$504.05	$588.24	$917.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $251.82 / $280.81 / $21,571.00	Facility		$251.82	$280.81	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $421.06 / $658.82 / $1,221.16	Professional		$421.06	$658.82	$1,221.16
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $251.82 / $280.81 / $1,907.69	Facility		$251.82	$280.81	$1,907.69
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $446.64 / $682.35 / $1,061.48	Professional		$446.64	$682.35	$1,061.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.28 / $351.54 / $607.21	Professional		$75.28	$351.54	$607.21
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 $449.40 / $617.49 / $1,104.74	Professional		$449.40	$617.49	$1,104.74