Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.41 / $284.51 / $11,581.00	Facility		$86.41	$284.51	$11,581.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.55 / $102.25 / $179.00	Professional		$78.55	$102.25	$179.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $109.26 / $148.08 / $241.46	Professional	50	$109.26	$148.08	$241.46
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 $74.00 / $103.74 / $207.01	Professional		$74.00	$103.74	$207.01
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $111.00 / $155.61 / $310.51	Professional	50	$111.00	$155.61	$310.51
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $81.77 / $97.42 / $97.42	Professional		$81.77	$97.42	$97.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $94.07 / $141.11 / $13,841.13	Facility		$94.07	$141.11	$13,841.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.95 / $107.76 / $168.11	Professional		$79.95	$107.76	$168.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $129.79 / $129.79 / $21,571.00	Facility		$129.79	$129.79	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.31 / $116.23 / $234.29	Professional		$75.31	$116.23	$234.29
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $75.31 / $117.03 / $198.73	Professional		$75.31	$117.03	$198.73
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $185.03 / $185.03 / $185.03	Professional	50	$185.03	$185.03	$185.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $82.48 / $112.43 / $154.20	Professional		$82.48	$112.43	$154.20
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 $81.63 / $115.41 / $201.23	Professional		$81.63	$115.41	$201.23