Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $1,949.84 / $10,715.19	Facility		$177.83	$1,949.84	$10,715.19
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $588.84 / $588.84 / $1,737.80	Facility	50	$588.84	$588.84	$1,737.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $154.88 / $363.08	Professional		$109.65	$154.88	$363.08
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $162.18 / $275.42 / $660.69	Professional	50	$162.18	$275.42	$660.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $125.89 / $134.90	Professional		$120.23	$125.89	$134.90
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $190.55 / $190.55 / $190.55	Professional	50	$190.55	$190.55	$190.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,137.96 / $3,981.07	Facility		$707.95	$2,137.96	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $123.03 / $229.09	Professional		$91.20	$123.03	$229.09
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $134.90 / $186.21 / $346.74	Professional	50	$134.90	$186.21	$346.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $141.25	Facility		$104.71	$104.71	$141.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Professional		$120.23	$120.23	$120.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $85.11 / $21,379.62	Facility		$77.62	$85.11	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $151.36 / $275.42	Professional		$107.15	$151.36	$275.42
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $501.19 / $21,379.62	Facility		$77.62	$501.19	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $151.36 / $275.42	Professional		$104.71	$151.36	$275.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $100.00 / $389.05	Facility		$46.77	$100.00	$389.05
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $138.04 / $288.40	Professional		$109.65	$138.04	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $912.01 / $2,951.21	Facility		$223.87	$912.01	$2,951.21
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $128.82 / $218.78	Professional		$95.50	$128.82	$218.78