Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $3,715.35 / $9,549.93	Facility		$245.47	$3,715.35	$9,549.93
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,318.26 / $3,890.45 / $9,332.54	Facility	50	$1,318.26	$3,890.45	$9,332.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $229.09 / $1,047.13	Professional		$141.25	$229.09	$1,047.13
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $234.42 / $436.52 / $1,202.26	Professional	50	$234.42	$436.52	$1,202.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $134.90 / $165.96	Professional		$75.86	$134.90	$165.96
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $208.93 / $229.09 / $269.15	Professional	50	$208.93	$229.09	$269.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $2,884.03 / $7,943.28	Facility		$1,000.00	$2,884.03	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $186.21 / $323.59	Professional		$144.54	$186.21	$323.59
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $218.78 / $281.84 / $467.74	Professional	50	$218.78	$281.84	$467.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $177.83 / $208.93	Facility		$151.36	$177.83	$208.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $204.17 / $354.81	Professional		$177.83	$204.17	$354.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $186.21 / $21,379.62	Facility		$131.83	$186.21	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $213.80 / $323.59	Professional		$158.49	$213.80	$323.59
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $1,148.15 / $2,951.21	Facility		$562.34	$1,148.15	$2,951.21
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $218.78 / $338.84	Professional		$154.88	$218.78	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $1,905.46	Facility		$100.00	$100.00	$1,905.46
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $181.97 / $295.12	Professional		$144.54	$181.97	$295.12
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $2,570.40 / $5,248.07	Facility		$1,698.24	$2,570.40	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $177.83 / $295.12	Professional		$134.90	$177.83	$295.12