Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $225.42 / $725.86 / $4,918.08	Facility		$225.42	$725.86	$4,918.08
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $119.59 / $177.83 / $493.03	Facility	54	$119.59	$177.83	$493.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.28 / $211.37 / $361.16	Professional		$144.28	$211.37	$361.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $168.31 / $190.15 / $242.20	Professional		$168.31	$190.15	$242.20
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 $126.57 / $178.69 / $314.37	Professional		$126.57	$178.69	$314.37
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $189.86 / $268.02 / $471.56	Professional	50	$189.86	$268.02	$471.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $172.08 / $215.10 / $255.58	Facility		$172.08	$215.10	$255.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $203.70 / $267.31 / $326.10	Professional		$203.70	$267.31	$326.10
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 $172.08 / $236.69 / $385.78	Professional		$172.08	$236.69	$385.78
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $312.55 / $492.20 / $1,127.32	Facility		$312.55	$492.20	$1,127.32
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $175.27 / $243.09 / $385.78	Professional		$175.27	$243.09	$385.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $148.34 / $200.82 / $289.48	Professional		$148.34	$200.82	$289.48
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $975.00 / $2,914.00	Facility		$444.00	$975.00	$2,914.00
United Facility/Professional Professional Modifier Low / Median / High Price $144.12 / $215.45 / $360.85	Professional		$144.12	$215.45	$360.85