Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $160.25 / $1,902.00 / $3,174.00	Facility		$160.25	$1,902.00	$3,174.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $31.72 / $72.59 / $200.66	Facility	52	$31.72	$72.59	$200.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.43 / $114.47 / $223.51	Professional		$63.43	$114.47	$223.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.29 / $102.31 / $128.53	Professional		$96.29	$102.31	$128.53
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 $70.89 / $113.69 / $195.90	Professional		$70.89	$113.69	$195.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $68.78 / $85.98 / $102.16	Facility		$68.78	$85.98	$102.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $134.65 / $159.13 / $278.70	Professional		$134.65	$159.13	$278.70
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 $82.54 / $141.44 / $245.57	Professional		$82.54	$141.44	$245.57
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $611.97 / $1,177.04 / $2,678.59	Facility		$611.97	$1,177.04	$2,678.59
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $85.97 / $146.54 / $245.57	Professional		$85.97	$146.54	$245.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.34 / $115.47 / $157.15	Professional		$85.34	$115.47	$157.15
United Facility/Professional Facility Modifier Low / Median / High Price $1,020.00 / $1,952.00 / $4,132.00	Facility		$1,020.00	$1,952.00	$4,132.00
United Facility/Professional Professional Modifier Low / Median / High Price $109.57 / $163.27 / $262.83	Professional		$109.57	$163.27	$262.83