Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $361.90 / $1,631.35 / $8,956.00	Facility		$361.90	$1,631.35	$8,956.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $226.58 / $336.93 / $808.01	Facility	54	$226.58	$336.93	$808.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $276.31 / $337.89 / $640.97	Professional		$276.31	$337.89	$640.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $450.38 / $450.38 / $450.38	Professional		$450.38	$450.38	$450.38
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 $194.84 / $297.41 / $505.14	Professional		$194.84	$297.41	$505.14
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $397.45 / $397.45 / $397.45	Professional		$397.45	$397.45	$397.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $277.17 / $302.36 / $440.29	Facility		$277.17	$302.36	$440.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $252.63 / $364.33 / $463.69	Professional		$252.63	$364.33	$463.69
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 $306.42 / $429.83 / $625.21	Professional		$306.42	$429.83	$625.21
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $317.27 / $489.34 / $3,653.15	Facility		$317.27	$489.34	$3,653.15
Medical Mutual of Ohio Facility/Professional Facility Modifier 54 Low / Median / High Price $370.70 / $370.70 / $370.70	Facility	54	$370.70	$370.70	$370.70
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $311.26 / $439.41 / $620.02	Professional		$311.26	$439.41	$620.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.85 / $236.12 / $429.85	Professional		$34.85	$236.12	$429.85
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $881.00 / $2,833.00	Facility		$444.00	$881.00	$2,833.00
United Facility/Professional Professional Modifier Low / Median / High Price $270.94 / $402.88 / $668.77	Professional		$270.94	$402.88	$668.77