Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $309.58 / $1,679.00 / $9,504.00	Facility		$309.58	$1,679.00	$9,504.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $191.75 / $285.14 / $656.18	Facility	54	$191.75	$285.14	$656.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $221.28 / $268.83 / $492.24	Professional		$221.28	$268.83	$492.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $814.00 / $1,927.00 / $3,943.00	Facility		$814.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $240.23 / $408.88	Professional		$170.48	$240.23	$408.88
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $332.08 / $332.08 / $332.08	Professional		$332.08	$332.08	$332.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $235.32 / $302.02 / $401.12	Facility		$235.32	$302.02	$401.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $304.39 / $387.42 / $127,498.73	Professional		$304.39	$387.42	$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 $252.94 / $352.36 / $513.60	Professional		$252.94	$352.36	$513.60
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $449.16 / $449.16 / $449.16	Facility		$449.16	$449.16	$449.16
Medical Mutual of Ohio Facility/Professional Facility Modifier 54 Low / Median / High Price $314.41 / $314.41 / $314.41	Facility	54	$314.41	$314.41	$314.41
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $264.27 / $362.53 / $504.12	Professional		$264.27	$362.53	$504.12
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 $213.57 / $333.80 / $545.42	Professional		$213.57	$333.80	$545.42