Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.89 / $131.29 / $3,196.73	Facility		$52.89	$131.29	$3,196.73
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $91.08 / $319.60 / $758.52	Facility	50	$91.08	$319.60	$758.52
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $16.66 / $56.00 / $117.74	Facility	52	$16.66	$56.00	$117.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.29 / $55.35 / $112.28	Professional		$30.29	$55.35	$112.28
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $70.00 / $98.87 / $293.26	Professional	50	$70.00	$98.87	$293.26
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.15 / $21.99 / $38.00	Professional	52	$15.15	$21.99	$38.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.20 / $39.69 / $62.26	Professional		$28.20	$39.69	$62.26
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $41.58 / $50.02 / $103.39	Professional	50	$41.58	$50.02	$103.39
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $10.28 / $10.28 / $10.28	Professional	52	$10.28	$10.28	$10.28
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 $10.32 / $21.13 / $62.25	Professional		$10.32	$21.13	$62.25
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $15.48 / $31.69 / $92.71	Professional	50	$15.48	$31.69	$92.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.32 / $37.90 / $45.03	Facility		$30.32	$37.90	$45.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $48.92 / $57.81 / $101.89	Professional		$48.92	$57.81	$101.89
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 $36.39 / $57.76 / $99.23	Professional		$36.39	$57.76	$99.23
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $43.75 / $79.23 / $247.08	Facility		$43.75	$79.23	$247.08
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $37.90 / $59.70 / $106.54	Professional		$37.90	$59.70	$106.54
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $81.02 / $81.02 / $81.02	Professional	50	$81.02	$81.02	$81.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.79 / $78.33 / $105.09	Professional		$57.79	$78.33	$105.09
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 $43.09 / $60.03 / $99.30	Professional		$43.09	$60.03	$99.30