Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $207.03 / $3,696.00 / $10,405.00	Facility		$207.03	$3,696.00	$10,405.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.62 / $207.03 / $646.05	Professional		$115.62	$207.03	$646.05
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $474.95 / $474.95 / $474.95	Professional	50	$474.95	$474.95	$474.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,152.00 / $2,897.00 / $8,800.00	Facility		$1,152.00	$2,897.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $164.61 / $659.65 / $1,124.04	Professional		$164.61	$659.65	$1,124.04
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $246.91 / $989.47 / $1,681.79	Professional	50	$246.91	$989.47	$1,681.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $117.58 / $141.10 / $187.40	Facility		$117.58	$141.10	$187.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $227.56 / $263.77 / $403.40	Professional		$227.56	$263.77	$403.40
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 $141.09 / $258.58 / $620.22	Professional		$141.09	$258.58	$620.22
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,041.74 / $1,535.12 / $1,705.38	Facility		$1,041.74	$1,535.12	$1,705.38
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $145.51 / $268.93 / $620.22	Professional		$145.51	$268.93	$620.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $172.02 / $230.95 / $314.30	Professional		$172.02	$230.95	$314.30
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $2,665.00 / $5,268.00	Facility		$1,689.00	$2,665.00	$5,268.00
United Facility/Professional Professional Modifier Low / Median / High Price $197.09 / $298.37 / $695.97	Professional		$197.09	$298.37	$695.97