Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $732.02 / $4,934.00 / $11,581.00	Facility		$732.02	$4,934.00	$11,581.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,652.27 / $2,652.27 / $6,843.00	Facility	50	$2,652.27	$2,652.27	$6,843.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $554.53 / $732.02 / $1,326.48	Professional		$554.53	$732.02	$1,326.48
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $859.24 / $1,106.78 / $1,380.55	Professional	50	$859.24	$1,106.78	$1,380.55
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $843.12 / $843.12 / $843.12	Professional	50	$843.12	$843.12	$843.12
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 $479.67 / $695.04 / $1,284.26	Professional		$479.67	$695.04	$1,284.26
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $719.50 / $1,042.56 / $1,926.39	Professional	50	$719.50	$1,042.56	$1,926.39
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $618.26 / $618.26 / $618.26	Professional		$618.26	$618.26	$618.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $711.27 / $872.00 / $1,289.18	Facility		$711.27	$872.00	$1,289.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $568.22 / $839.71 / $1,309.95	Professional		$568.22	$839.71	$1,309.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $949.77 / $983.65 / $21,571.00	Facility		$949.77	$983.65	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $547.13 / $806.13 / $1,416.20	Professional		$547.13	$806.13	$1,416.20
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $949.77 / $1,059.09 / $2,891.30	Facility		$949.77	$1,059.09	$2,891.30
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $543.23 / $830.59 / $1,258.39	Professional		$543.23	$830.59	$1,258.39
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $1,165.49 / $1,165.49 / $1,165.49	Professional	50	$1,165.49	$1,165.49	$1,165.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.18 / $515.78 / $898.81	Professional		$76.18	$515.78	$898.81
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $4,072.00 / $6,522.00	Facility		$1,981.00	$4,072.00	$6,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $624.94 / $777.64 / $1,569.53	Professional		$624.94	$777.64	$1,569.53