Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $643.80 / $3,696.00 / $11,243.00	Facility		$643.80	$3,696.00	$11,243.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,656.00 / $2,805.90 / $5,912.74	Facility	50	$1,656.00	$2,805.90	$5,912.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $479.36 / $643.80 / $1,144.83	Professional		$479.36	$643.80	$1,144.83
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $316.32 / $414.06 / $1,121.92	Professional	50	$316.32	$414.06	$1,121.92
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $322.49 / $322.49 / $827.64	Professional	50	$322.49	$322.49	$827.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,145.00 / $2,792.00 / $8,800.00	Facility		$1,145.00	$2,792.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $394.17 / $591.20 / $1,115.76	Professional		$394.17	$591.20	$1,115.76
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $591.25 / $886.80 / $1,673.64	Professional	50	$591.25	$886.80	$1,673.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $605.19 / $741.95 / $1,289.18	Facility		$605.19	$741.95	$1,289.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $468.97 / $739.94 / $1,154.31	Professional		$468.97	$739.94	$1,154.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $836.80 / $949.77 / $21,571.00	Facility		$836.80	$949.77	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $472.91 / $700.98 / $1,239.95	Professional		$472.91	$700.98	$1,239.95
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $949.77 / $949.77 / $1,059.09	Facility		$949.77	$949.77	$1,059.09
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $476.78 / $736.89 / $1,081.41	Professional		$476.78	$736.89	$1,081.41
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $497.21 / $497.21 / $497.21	Professional	50	$497.21	$497.21	$497.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.13 / $443.45 / $785.76	Professional		$75.13	$443.45	$785.76
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $4,138.00 / $6,522.00	Facility		$1,981.00	$4,138.00	$6,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $496.19 / $660.44 / $1,249.06	Professional		$496.19	$660.44	$1,249.06