Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $5,128.61 / $12,022.64	Facility		$812.83	$5,128.61	$12,022.64
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,630.27 / $3,715.35 / $12,589.25	Facility	50	$2,630.27	$3,715.35	$12,589.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $870.96 / $1,862.09	Professional		$588.84	$870.96	$1,862.09
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $794.33 / $1,288.25 / $2,041.74	Professional	50	$794.33	$1,288.25	$2,041.74
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $776.25 / $776.25 / $870.96	Professional	50	$776.25	$776.25	$870.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $2,884.03 / $7,943.28	Facility		$1,071.52	$2,884.03	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $707.95 / $1,258.93	Professional		$524.81	$707.95	$1,258.93
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $794.33 / $1,071.52 / $1,905.46	Professional	50	$794.33	$1,071.52	$1,905.46
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Professional		$616.60	$616.60	$616.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $707.95 / $1,288.25	Facility		$707.95	$707.95	$1,288.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $602.56 / $602.56	Professional		$602.56	$602.56	$602.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,047.13 / $21,379.62	Facility		$954.99	$1,047.13	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $794.33 / $1,348.96	Professional		$537.03	$794.33	$1,348.96
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $2,884.03 / $21,379.62	Facility		$794.33	$2,884.03	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $794.33 / $1,348.96	Professional		$501.19	$794.33	$1,348.96
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $1,174.90 / $1,174.90 / $1,174.90	Professional	50	$1,174.90	$1,174.90	$1,174.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $295.12	Professional		$32.36	$33.11	$295.12
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $562.34 / $2,951.21	Facility		$100.00	$562.34	$2,951.21
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $776.25 / $1,513.56	Professional		$537.03	$776.25	$1,513.56
United Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $4,265.80 / $7,244.36	Facility		$1,778.28	$4,265.80	$7,244.36
United Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $724.44 / $1,230.27	Professional		$501.19	$724.44	$1,230.27