Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $379.00 / $1,087.78 / $9,504.00	Facility		$379.00	$1,087.78	$9,504.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $232.68 / $346.00 / $815.84	Facility	54	$232.68	$346.00	$815.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $276.06 / $345.15 / $610.04	Professional		$276.06	$345.15	$610.04
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 $199.44 / $291.95 / $496.76	Professional		$199.44	$291.95	$496.76
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $407.74 / $407.74 / $407.74	Professional		$407.74	$407.74	$407.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $284.36 / $364.96 / $484.71	Facility		$284.36	$364.96	$484.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $373.76 / $475.69 / $127,498.73	Professional		$373.76	$475.69	$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 $306.39 / $428.66 / $629.03	Professional		$306.39	$428.66	$629.03
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $542.54 / $542.54 / $542.54	Facility		$542.54	$542.54	$542.54
Medical Mutual of Ohio Facility/Professional Facility Modifier 54 Low / Median / High Price $379.78 / $379.78 / $379.78	Facility	54	$379.78	$379.78	$379.78
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $319.33 / $441.72 / $621.74	Professional		$319.33	$441.72	$621.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.77 / $226.42 / $418.03	Professional		$34.77	$226.42	$418.03
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 $268.51 / $407.38 / $689.39	Professional		$268.51	$407.38	$689.39