Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $383.79 / $736.88 / $6,582.00	Facility		$383.79	$736.88	$6,582.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $149.24 / $244.92 / $508.60	Facility	52	$149.24	$244.92	$508.60
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $223.86 / $332.88 / $762.89	Facility	54	$223.86	$332.88	$762.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $254.15 / $329.41 / $588.00	Professional		$254.15	$329.41	$588.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $195.01 / $369.48 / $1,052.27	Professional		$195.01	$369.48	$1,052.27
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 $199.52 / $284.02 / $478.30	Professional		$199.52	$284.02	$478.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $274.18 / $351.89 / $467.36	Facility		$274.18	$351.89	$467.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $356.28 / $453.45 / $127,498.73	Professional		$356.28	$453.45	$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 $298.58 / $410.54 / $583.00	Professional		$298.58	$410.54	$583.00
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $147.02 / $451.92 / $1,173.76	Facility		$147.02	$451.92	$1,173.76
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $419.02 / $419.02 / $419.02	Facility	52	$419.02	$419.02	$419.02
Medical Mutual of Ohio Facility/Professional Facility Modifier 54 Low / Median / High Price $366.64 / $366.64 / $366.64	Facility	54	$366.64	$366.64	$366.64
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $305.19 / $421.05 / $583.00	Professional		$305.19	$421.05	$583.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.85 / $213.48 / $429.84	Professional		$34.85	$213.48	$429.84
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 $231.91 / $367.36 / $565.59	Professional		$231.91	$367.36	$565.59