Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $3,630.78 / $10,715.19	Facility		$190.55	$3,630.78	$10,715.19
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,023.29 / $1,584.89 / $2,187.76	Facility	50	$1,023.29	$1,584.89	$2,187.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $186.21 / $549.54	Professional		$112.20	$186.21	$549.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $363.08 / $457.09 / $1,174.90	Professional	50	$363.08	$457.09	$1,174.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $208.93	Professional		$199.53	$199.53	$208.93
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 $93.33 / $158.49 / $281.84	Professional		$93.33	$158.49	$281.84
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $138.04 / $234.42 / $416.87	Professional	50	$138.04	$234.42	$416.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $123.03 / $134.90	Facility		$112.20	$123.03	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $190.55 / $21,379.62	Facility		$100.00	$190.55	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $208.93 / $346.74	Professional		$123.03	$208.93	$346.74
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $295.12 / $21,379.62	Facility		$295.12	$295.12	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $213.80 / $346.74	Professional		$128.82	$213.80	$346.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $288.40	Facility		$100.00	$100.00	$288.40
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $190.55 / $354.81	Professional		$109.65	$190.55	$354.81
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $912.01 / $2,951.21	Facility		$316.23	$912.01	$2,951.21
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $177.83 / $309.03	Professional		$112.20	$177.83	$309.03