Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $146.21 / $435.22 / $3,174.00	Facility		$146.21	$435.22	$3,174.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $68.70 / $102.17 / $281.36	Facility	54	$68.70	$102.17	$281.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.10 / $132.83 / $219.98	Professional		$86.10	$132.83	$219.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.89 / $106.63 / $164.05	Professional		$87.89	$106.63	$164.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $777.00 / $1,765.00 / $3,943.00	Facility		$777.00	$1,765.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.93 / $101.74 / $180.55	Professional		$68.93	$101.74	$180.55
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $132.41 / $132.41 / $132.41	Professional		$132.41	$132.41	$132.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $99.50 / $124.38 / $146.66	Facility		$99.50	$124.38	$146.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $121.55 / $158.19 / $192.99	Professional		$121.55	$158.19	$192.99
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 $98.15 / $135.54 / $221.36	Professional		$98.15	$135.54	$221.36
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $172.46 / $352.68 / $675.44	Facility		$172.46	$352.68	$675.44
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $99.35 / $139.81 / $224.39	Professional		$99.35	$139.81	$224.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $110.13 / $155.52	Professional		$81.79	$110.13	$155.52
United Facility/Professional Facility Modifier Low / Median / High Price $467.00 / $1,009.00 / $3,398.00	Facility		$467.00	$1,009.00	$3,398.00
United Facility/Professional Professional Modifier Low / Median / High Price $89.73 / $124.15 / $210.34	Professional		$89.73	$124.15	$210.34