Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $172.27 / $1,000.00 / $9,496.00	Facility		$172.27	$1,000.00	$9,496.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $709.80 / $1,507.76 / $1,677.46	Facility	50	$709.80	$1,507.76	$1,677.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.87 / $157.71 / $379.32	Professional		$109.87	$157.71	$379.32
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $172.76 / $281.73 / $1,159.50	Professional	50	$172.76	$281.73	$1,159.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.87 / $115.74 / $127.39	Professional		$57.87	$115.74	$127.39
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $173.60 / $182.40 / $237.12	Professional	50	$173.60	$182.40	$237.12
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 $84.87 / $125.99 / $257.14	Professional		$84.87	$125.99	$257.14
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $124.46 / $188.99 / $385.72	Professional	50	$124.46	$188.99	$385.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $107.18 / $139.33 / $170.82	Facility		$107.18	$139.33	$170.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $130.75 / $163.13 / $215.33	Professional		$130.75	$163.13	$215.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.14 / $93.82 / $21,571.00	Facility		$84.14	$93.82	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.11 / $163.44 / $300.00	Professional		$111.11	$163.44	$300.00
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $84.14 / $435.72 / $491.13	Facility		$84.14	$435.72	$491.13
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $107.75 / $164.41 / $270.00	Professional		$107.75	$164.41	$270.00
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $102.19 / $102.19 / $102.19	Professional	50	$102.19	$102.19	$102.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $91.28 / $128.29 / $185.45	Professional		$91.28	$128.29	$185.45
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 $125.81 / $158.37 / $325.77	Professional		$125.81	$158.37	$325.77