Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $319.14 / $595.96 / $3,186.00	Facility		$319.14	$595.96	$3,186.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $239.36 / $355.92 / $781.19	Facility	54	$239.36	$355.92	$781.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $241.69 / $361.46 / $694.49	Professional		$241.69	$361.46	$694.49
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $804.24 / $1,038.72 / $1,670.00	Professional	50	$804.24	$1,038.72	$1,670.00
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $202.91 / $249.82 / $451.69	Professional	54	$202.91	$249.82	$451.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $210.34 / $405.05 / $507.63	Professional		$210.34	$405.05	$507.63
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 $188.78 / $272.02 / $464.18	Professional		$188.78	$272.02	$464.18
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $283.17 / $407.75 / $696.27	Professional	50	$283.17	$407.75	$696.27
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $360.25 / $383.18 / $393.00	Professional		$360.25	$383.18	$393.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $314.54 / $377.45 / $471.81	Facility		$314.54	$377.45	$471.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $336.61 / $425.75 / $638.63	Professional		$336.61	$425.75	$638.63
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 $310.22 / $424.86 / $613.26	Professional		$310.22	$424.86	$613.26
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $215.11 / $365.98 / $574.79	Facility		$215.11	$365.98	$574.79
Medical Mutual of Ohio Facility/Professional Facility Modifier 54 Low / Median / High Price $392.49 / $392.49 / $392.49	Facility	54	$392.49	$392.49	$392.49
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $310.22 / $434.24 / $621.03	Professional		$310.22	$434.24	$621.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.85 / $225.80 / $418.03	Professional		$34.85	$225.80	$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 $251.48 / $383.59 / $647.55	Professional		$251.48	$383.59	$647.55