Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $250.09 / $2,113.00 / $10,268.00	Facility		$250.09	$2,113.00	$10,268.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $175.66 / $261.20 / $548.73	Facility	54	$175.66	$261.20	$548.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.78 / $234.21 / $412.73	Professional		$200.78	$234.21	$412.73
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 $148.91 / $215.30 / $361.04	Professional		$148.91	$215.30	$361.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $214.52 / $275.33 / $365.67	Facility		$214.52	$275.33	$365.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $254.00 / $323.27 / $127,498.73	Professional		$254.00	$323.27	$127,498.73
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 $228.79 / $311.73 / $440.32	Professional		$228.79	$311.73	$440.32
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $409.29 / $409.29 / $409.29	Facility		$409.29	$409.29	$409.29
Medical Mutual of Ohio Facility/Professional Facility Modifier 54 Low / Median / High Price $286.50 / $286.50 / $286.50	Facility	54	$286.50	$286.50	$286.50
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $229.72 / $318.68 / $440.32	Professional		$229.72	$318.68	$440.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.41 / $190.53 / $290.70	Professional		$32.41	$190.53	$290.70
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 $182.20 / $275.66 / $466.10	Professional		$182.20	$275.66	$466.10