Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.81 / $158.60 / $3,696.00	Facility		$23.81	$158.60	$3,696.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.63 / $19.93 / $47.93	Professional		$13.63	$19.93	$47.93
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $24.81 / $33.97 / $90.42	Professional	50	$24.81	$33.97	$90.42
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $7.01 / $7.01 / $11.99	Professional	52	$7.01	$7.01	$11.99
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $2.80 / $2.80 / $4.58	Professional	53	$2.80	$2.80	$4.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $10.98 / $13.89 / $18.05	Professional		$10.98	$13.89	$18.05
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $17.71 / $21.25 / $29.17	Professional	50	$17.71	$21.25	$29.17
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 $10.08 / $14.32 / $23.07	Professional		$10.08	$14.32	$23.07
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $15.13 / $21.49 / $34.60	Professional	50	$15.13	$21.49	$34.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.89 / $17.36 / $20.63	Facility		$13.89	$17.36	$20.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.28 / $18.05 / $30.75	Professional		$15.28	$18.05	$30.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,571.00 / $21,571.00 / $21,571.00	Facility		$21,571.00	$21,571.00	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.52 / $18.05 / $28.18	Professional		$13.52	$18.05	$28.18
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $33.84 / $74.03 / $125.96	Facility		$33.84	$74.03	$125.96
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $13.60 / $19.26 / $29.17	Professional		$13.60	$19.26	$29.17
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $33.75 / $33.75 / $33.75	Professional	50	$33.75	$33.75	$33.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.95 / $10.95 / $10.95	Professional		$10.95	$10.95	$10.95
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $979.00 / $3,218.00	Facility		$444.00	$979.00	$3,218.00
United Facility/Professional Professional Modifier Low / Median / High Price $12.27 / $17.21 / $27.58	Professional		$12.27	$17.21	$27.58