Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $614.05 / $4,723.00 / $11,581.00	Facility		$614.05	$4,723.00	$11,581.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $424.94 / $614.05 / $1,053.10	Professional		$424.94	$614.05	$1,053.10
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $210.69 / $210.69 / $629.27	Professional	50	$210.69	$210.69	$629.27
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 $386.22 / $544.52 / $1,034.67	Professional		$386.22	$544.52	$1,034.67
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $579.33 / $816.78 / $1,552.01	Professional	50	$579.33	$816.78	$1,552.01
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $474.05 / $474.05 / $474.05	Professional		$474.05	$474.05	$474.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $545.36 / $668.60 / $1,289.18	Facility		$545.36	$668.60	$1,289.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $463.56 / $702.30 / $1,095.58	Professional		$463.56	$702.30	$1,095.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $753.83 / $949.77 / $21,571.00	Facility		$753.83	$949.77	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $432.81 / $651.05 / $1,171.11	Professional		$432.81	$651.05	$1,171.11
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 $440.49 / $674.21 / $1,026.34	Professional		$440.49	$674.21	$1,026.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.13 / $419.41 / $758.96	Professional		$75.13	$419.41	$758.96
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 $516.41 / $639.84 / $1,305.10	Professional		$516.41	$639.84	$1,305.10