Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $387.64 / $3,696.00 / $9,504.00	Facility		$387.64	$3,696.00	$9,504.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $898.28 / $2,695.92 / $4,998.55	Facility	50	$898.28	$2,695.92	$4,998.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $267.69 / $352.40 / $676.60	Professional		$267.69	$352.40	$676.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $622.44 / $925.04 / $3,143.11	Professional	50	$622.44	$925.04	$3,143.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,152.00 / $2,792.00 / $8,800.00	Facility		$1,152.00	$2,792.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.14 / $373.83 / $630.69	Professional		$245.14	$373.83	$630.69
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $367.71 / $560.75 / $938.32	Professional	50	$367.71	$560.75	$938.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $270.88 / $325.06 / $507.90	Facility		$270.88	$325.06	$507.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $389.38 / $389.38 / $690.26	Professional		$389.38	$389.38	$690.26
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 $294.58 / $431.14 / $690.19	Professional		$294.58	$431.14	$690.19
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $833.55 / $1,360.59 / $3,312.47	Facility		$833.55	$1,360.59	$3,312.47
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $311.51 / $442.47 / $731.72	Professional		$311.51	$442.47	$731.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.15 / $356.65 / $532.82	Professional		$33.15	$356.65	$532.82
United Facility/Professional Facility Modifier Low / Median / High Price $2,233.00 / $4,383.00 / $6,522.00	Facility		$2,233.00	$4,383.00	$6,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $335.59 / $465.55 / $773.14	Professional		$335.59	$465.55	$773.14