Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $556.63 / $3,671.00 / $7,647.64	Facility		$556.63	$3,671.00	$7,647.64
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $28.14 / $91.12 / $402.82	Facility	53	$28.14	$91.12	$402.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.71 / $392.00 / $761.21	Professional		$140.71	$392.00	$761.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $139.06 / $297.98 / $360.21	Professional		$139.06	$297.98	$360.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,145.00 / $2,786.00 / $8,800.00	Facility		$1,145.00	$2,786.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $168.59 / $475.00 / $968.83	Professional		$168.59	$475.00	$968.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $152.81 / $191.01 / $226.96	Facility		$152.81	$191.01	$226.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $483.80 / $571.77 / $986.99	Professional		$483.80	$571.77	$986.99
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 $176.36 / $483.81 / $986.72	Professional		$176.36	$483.81	$986.72
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,703.83 / $3,151.59 / $5,080.88	Facility		$1,703.83	$3,151.59	$5,080.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $178.79 / $483.81 / $986.72	Professional		$178.79	$483.81	$986.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $397.46 / $537.79 / $737.65	Professional		$397.46	$537.79	$737.65
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 $527.78 / $750.95 / $1,183.08	Professional		$527.78	$750.95	$1,183.08