Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $356.00 / $1,679.00 / $9,504.00	Facility		$356.00	$1,679.00	$9,504.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $248.03 / $368.82 / $852.03	Facility	54	$248.03	$368.82	$852.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $291.82 / $358.00 / $630.05	Professional		$291.82	$358.00	$630.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $311.38 / $311.38 / $544.20	Professional		$311.38	$311.38	$544.20
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 $211.81 / $312.47 / $530.16	Professional		$211.81	$312.47	$530.16
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $420.90 / $420.90 / $420.90	Professional		$420.90	$420.90	$420.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $302.87 / $388.72 / $516.27	Facility		$302.87	$388.72	$516.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $385.83 / $491.05 / $127,498.73	Professional		$385.83	$491.05	$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 $327.33 / $453.51 / $655.03	Professional		$327.33	$453.51	$655.03
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $578.13 / $578.13 / $578.13	Facility		$578.13	$578.13	$578.13
Medical Mutual of Ohio Facility/Professional Facility Modifier 54 Low / Median / High Price $404.69 / $404.69 / $404.69	Facility	54	$404.69	$404.69	$404.69
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $340.13 / $467.83 / $653.61	Professional		$340.13	$467.83	$653.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.85 / $247.91 / $443.95	Professional		$34.85	$247.91	$443.95
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 $278.25 / $418.68 / $697.57	Professional		$278.25	$418.68	$697.57