Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $379.00 / $709.80 / $8,553.00	Facility		$379.00	$709.80	$8,553.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $260.41 / $387.23 / $906.17	Facility	54	$260.41	$387.23	$906.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $311.50 / $377.84 / $733.58	Professional		$311.50	$377.84	$733.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $342.28 / $342.28 / $342.28	Professional		$342.28	$342.28	$342.28
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 $251.56 / $349.39 / $562.16	Professional		$251.56	$349.39	$562.16
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $407.35 / $407.35 / $407.35	Professional		$407.35	$407.35	$407.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $317.87 / $407.96 / $541.83	Facility		$317.87	$407.96	$541.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $407.35 / $518.45 / $127,498.73	Professional		$407.35	$518.45	$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 $346.27 / $480.41 / $692.91	Professional		$346.27	$480.41	$692.91
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $439.49 / $439.49 / $606.91	Facility		$439.49	$439.49	$606.91
Medical Mutual of Ohio Facility/Professional Facility Modifier 54 Low / Median / High Price $424.84 / $424.84 / $424.84	Facility	54	$424.84	$424.84	$424.84
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $356.96 / $492.95 / $690.59	Professional		$356.96	$492.95	$690.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.85 / $268.81 / $496.46	Professional		$34.85	$268.81	$496.46
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 $295.04 / $444.01 / $746.28	Professional		$295.04	$444.01	$746.28