Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $918.69 / $4,197.00 / $10,268.00	Facility		$918.69	$4,197.00	$10,268.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,783.50 / $3,783.50 / $3,783.50	Facility	50	$3,783.50	$3,783.50	$3,783.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $515.22 / $581.30 / $1,468.37	Professional		$515.22	$581.30	$1,468.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $703.63 / $703.63 / $703.63	Professional		$703.63	$703.63	$703.63
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 $408.07 / $551.50 / $982.77	Professional		$408.07	$551.50	$982.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $668.64 / $819.74 / $1,289.18	Facility		$668.64	$819.74	$1,289.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $461.35 / $642.92 / $1,002.96	Professional		$461.35	$642.92	$1,002.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $619.97 / $949.77 / $21,571.00	Facility		$619.97	$949.77	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $462.96 / $668.64 / $1,107.78	Professional		$462.96	$668.64	$1,107.78
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 $467.11 / $685.62 / $1,043.06	Professional		$467.11	$685.62	$1,043.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.18 / $388.47 / $699.97	Professional		$76.18	$388.47	$699.97
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 $457.90 / $591.14 / $1,198.55	Professional		$457.90	$591.14	$1,198.55