Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $5,370.32 / $11,748.98	Facility		$660.69	$5,370.32	$11,748.98
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,041.74 / $2,041.74 / $5,888.44	Facility	50	$2,041.74	$2,041.74	$5,888.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $537.03 / $1,288.25	Professional		$398.11	$537.03	$1,288.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $524.81 / $1,445.44 / $2,570.40	Professional	50	$524.81	$1,445.44	$2,570.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $645.65 / $645.65	Professional		$645.65	$645.65	$645.65
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $977.24 / $977.24 / $977.24	Professional	50	$977.24	$977.24	$977.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $2,818.38 / $7,943.28	Facility		$1,071.52	$2,818.38	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $467.74 / $851.14	Professional		$371.54	$467.74	$851.14
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $562.34 / $707.95 / $1,288.25	Professional	50	$562.34	$707.95	$1,288.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $512.86 / $1,288.25	Facility		$512.86	$512.86	$1,288.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $436.52 / $436.52	Professional		$436.52	$436.52	$436.52
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 $398.11 / $575.44 / $977.24	Professional		$398.11	$575.44	$977.24
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,047.13 / $21,379.62	Facility		$741.31	$1,047.13	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $575.44 / $977.24	Professional		$398.11	$575.44	$977.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $245.47	Professional		$32.36	$33.11	$245.47
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 $398.11 / $562.34 / $1,071.52	Professional		$398.11	$562.34	$1,071.52
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 $371.54 / $501.19 / $870.96	Professional		$371.54	$501.19	$870.96