Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $324.93 / $2,432.00 / $9,504.00	Facility		$324.93	$2,432.00	$9,504.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $220.28 / $327.55 / $770.52	Facility	54	$220.28	$327.55	$770.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $260.51 / $314.83 / $567.22	Professional		$260.51	$314.83	$567.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $432.57 / $432.57 / $484.48	Professional		$432.57	$432.57	$484.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $2,012.00 / $3,943.00	Facility		$937.00	$2,012.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.66 / $298.39 / $483.92	Professional		$204.66	$298.39	$483.92
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $382.13 / $382.13 / $382.13	Professional		$382.13	$382.13	$382.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $269.63 / $294.14 / $428.32	Facility		$269.63	$294.14	$428.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $245.28 / $350.28 / $445.82	Professional		$245.28	$350.28	$445.82
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 $294.61 / $413.76 / $598.30	Professional		$294.61	$413.76	$598.30
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $514.65 / $514.65 / $514.65	Facility		$514.65	$514.65	$514.65
Medical Mutual of Ohio Facility/Professional Facility Modifier 54 Low / Median / High Price $360.25 / $360.25 / $360.25	Facility	54	$360.25	$360.25	$360.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $302.80 / $419.87 / $591.82	Professional		$302.80	$419.87	$591.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.53 / $160.35 / $420.90	Professional		$32.53	$160.35	$420.90
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 $235.70 / $374.51 / $578.45	Professional		$235.70	$374.51	$578.45