Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $215.01 / $1,967.00 / $9,534.00	Facility		$215.01	$1,967.00	$9,534.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,754.40 / $1,754.40 / $1,754.40	Facility	50	$1,754.40	$1,754.40	$1,754.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.44 / $199.60 / $403.26	Professional		$133.44	$199.60	$403.26
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $347.16 / $347.16 / $383.30	Professional	50	$347.16	$347.16	$383.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,927.00 / $3,943.00	Facility		$937.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.53 / $172.44 / $344.10	Professional		$103.53	$172.44	$344.10
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $155.30 / $258.66 / $516.15	Professional	50	$155.30	$258.66	$516.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $174.84 / $214.35 / $262.26	Facility		$174.84	$214.35	$262.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $148.61 / $244.73 / $381.77	Professional		$148.61	$244.73	$381.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $135.35 / $150.93 / $21,571.00	Facility		$135.35	$150.93	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.21 / $216.30 / $387.83	Professional		$141.21	$216.30	$387.83
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $135.35 / $135.35 / $150.93	Facility		$135.35	$135.35	$150.93
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $147.47 / $225.15 / $370.92	Professional		$147.47	$225.15	$370.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $154.93 / $222.70 / $316.01	Professional		$154.93	$222.70	$316.01
United Facility/Professional Facility Modifier Low / Median / High Price $226.00 / $881.00 / $2,833.00	Facility		$226.00	$881.00	$2,833.00
United Facility/Professional Professional Modifier Low / Median / High Price $179.34 / $221.75 / $469.03	Professional		$179.34	$221.75	$469.03