Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $587.47 / $4,731.00 / $11,243.00	Facility		$587.47	$4,731.00	$11,243.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,899.74 / $2,032.55 / $5,855.10	Facility	50	$1,899.74	$2,032.55	$5,855.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $412.83 / $534.05 / $916.05	Professional		$412.83	$534.05	$916.05
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $78.04 / $691.03 / $780.44	Professional	50	$78.04	$691.03	$780.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $224.52 / $489.86 / $514.63	Professional		$224.52	$489.86	$514.63
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 $359.12 / $476.58 / $864.90	Professional		$359.12	$476.58	$864.90
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $538.67 / $712.56 / $1,297.34	Professional	50	$538.67	$712.56	$1,297.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $514.63 / $630.91 / $1,289.18	Facility		$514.63	$630.91	$1,289.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $437.44 / $612.34 / $955.25	Professional		$437.44	$612.34	$955.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $710.96 / $949.77 / $21,571.00	Facility		$710.96	$949.77	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $397.62 / $587.85 / $1,031.96	Professional		$397.62	$587.85	$1,031.96
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $896.30 / $949.77 / $2,418.59	Facility		$896.30	$949.77	$2,418.59
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $397.37 / $603.73 / $906.15	Professional		$397.37	$603.73	$906.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $74.89 / $360.86 / $607.62	Professional		$74.89	$360.86	$607.62
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 $432.38 / $539.15 / $1,092.72	Professional		$432.38	$539.15	$1,092.72