Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $332.57 / $1,872.00 / $11,581.00	Facility		$332.57	$1,872.00	$11,581.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $216.98 / $322.64 / $745.12	Facility	54	$216.98	$322.64	$745.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.28 / $301.69 / $518.04	Professional		$251.28	$301.69	$518.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $337.34 / $337.34 / $337.34	Professional		$337.34	$337.34	$337.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,981.00 / $3,943.00	Facility		$937.00	$1,981.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.58 / $281.72 / $467.28	Professional		$198.58	$281.72	$467.28
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $355.03 / $355.03 / $355.03	Professional		$355.03	$355.03	$355.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $265.06 / $289.14 / $421.04	Facility		$265.06	$289.14	$421.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $227.13 / $325.45 / $414.20	Professional		$227.13	$325.45	$414.20
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 $289.94 / $396.88 / $568.41	Professional		$289.94	$396.88	$568.41
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $506.07 / $506.07 / $506.07	Facility		$506.07	$506.07	$506.07
Medical Mutual of Ohio Facility/Professional Facility Modifier 54 Low / Median / High Price $354.25 / $354.25 / $354.25	Facility	54	$354.25	$354.25	$354.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $295.86 / $400.69 / $568.41	Professional		$295.86	$400.69	$568.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.85 / $229.47 / $369.70	Professional		$34.85	$229.47	$369.70
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $965.00 / $2,914.00	Facility		$444.00	$965.00	$2,914.00
United Facility/Professional Professional Modifier Low / Median / High Price $238.78 / $361.68 / $582.91	Professional		$238.78	$361.68	$582.91