Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.81 / $1,109.00 / $9,504.00	Facility		$288.81	$1,109.00	$9,504.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $198.64 / $295.37 / $690.23	Facility	54	$198.64	$295.37	$690.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $236.65 / $284.54 / $509.70	Professional		$236.65	$284.54	$509.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $437.32 / $437.32 / $624.74	Professional		$437.32	$437.32	$624.74
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 $176.91 / $255.51 / $429.36	Professional		$176.91	$255.51	$429.36
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $340.66 / $340.66 / $340.66	Professional		$340.66	$340.66	$340.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $243.39 / $312.37 / $386.62	Facility		$243.39	$312.37	$386.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $312.27 / $397.43 / $127,498.73	Professional		$312.27	$397.43	$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 $264.52 / $366.21 / $528.95	Professional		$264.52	$366.21	$528.95
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $376.97 / $376.97 / $464.51	Facility		$376.97	$376.97	$464.51
Medical Mutual of Ohio Facility/Professional Facility Modifier 54 Low / Median / High Price $325.16 / $325.16 / $325.16	Facility	54	$325.16	$325.16	$325.16
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $273.33 / $377.45 / $526.02	Professional		$273.33	$377.45	$526.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.77 / $195.89 / $372.78	Professional		$34.77	$195.89	$372.78
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 $223.82 / $339.25 / $566.78	Professional		$223.82	$339.25	$566.78