Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $465.00 / $2,057.69 / $7,085.00	Facility		$465.00	$2,057.69	$7,085.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $377.59 / $561.47 / $1,298.48	Facility	54	$377.59	$561.47	$1,298.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $499.55 / $578.96 / $1,111.01	Professional		$499.55	$578.96	$1,111.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $344.69 / $527.39 / $596.99	Professional		$344.69	$527.39	$596.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,145.00 / $2,792.00 / $8,800.00	Facility		$1,145.00	$2,792.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $420.36 / $576.02 / $909.47	Professional		$420.36	$576.02	$909.47
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $556.42 / $590.90 / $624.85	Professional		$556.42	$590.90	$624.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $460.42 / $590.90 / $784.80	Facility		$460.42	$590.90	$784.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $572.78 / $728.99 / $127,498.73	Professional		$572.78	$728.99	$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 $511.58 / $724.29 / $1,021.96	Professional		$511.58	$724.29	$1,021.96
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $538.36 / $868.94 / $2,172.10	Facility		$538.36	$868.94	$2,172.10
Medical Mutual of Ohio Facility/Professional Facility Modifier 54 Low / Median / High Price $615.99 / $615.99 / $615.99	Facility	54	$615.99	$615.99	$615.99
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $517.04 / $740.08 / $1,009.08	Professional		$517.04	$740.08	$1,009.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $71.67 / $366.18 / $629.22	Professional		$71.67	$366.18	$629.22
United Facility/Professional Facility Modifier Low / Median / High Price $1,020.00 / $1,940.00 / $4,067.00	Facility		$1,020.00	$1,940.00	$4,067.00
United Facility/Professional Professional Modifier Low / Median / High Price $430.64 / $661.71 / $1,105.84	Professional		$430.64	$661.71	$1,105.84