Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $462.61 / $2,849.00 / $10,268.00	Facility		$462.61	$2,849.00	$10,268.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $316.02 / $469.92 / $1,118.03	Facility	54	$316.02	$469.92	$1,118.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.30 / $462.61 / $827.83	Professional		$389.30	$462.61	$827.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,145.00 / $2,792.00 / $8,800.00	Facility		$1,145.00	$2,792.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.37 / $463.92 / $739.14	Professional		$331.37	$463.92	$739.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $385.24 / $494.42 / $656.66	Facility		$385.24	$494.42	$656.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $497.64 / $633.36 / $127,498.73	Professional		$497.64	$633.36	$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 $432.63 / $597.44 / $852.71	Professional		$432.63	$597.44	$852.71
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $736.07 / $736.07 / $736.07	Facility		$736.07	$736.07	$736.07
Medical Mutual of Ohio Facility/Professional Facility Modifier 54 Low / Median / High Price $515.25 / $515.25 / $515.25	Facility	54	$515.25	$515.25	$515.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $432.63 / $607.73 / $852.71	Professional		$432.63	$607.73	$852.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $71.16 / $334.93 / $583.98	Professional		$71.16	$334.93	$583.98
United Facility/Professional Facility Modifier Low / Median / High Price $2,233.00 / $4,223.00 / $6,522.00	Facility		$2,233.00	$4,223.00	$6,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $382.58 / $556.94 / $933.74	Professional		$382.58	$556.94	$933.74