Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $287.20 / $464.42 / $9,504.00	Facility		$287.20	$464.42	$9,504.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $196.52 / $292.23 / $665.90	Facility	54	$196.52	$292.23	$665.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $222.40 / $281.73 / $506.40	Professional		$222.40	$281.73	$506.40
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 $166.78 / $243.92 / $416.02	Professional		$166.78	$243.92	$416.02
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $338.83 / $338.83 / $338.83	Professional		$338.83	$338.83	$338.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $241.14 / $263.06 / $383.05	Facility		$241.14	$263.06	$383.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $210.94 / $310.60 / $395.30	Professional		$210.94	$310.60	$395.30
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 $262.19 / $361.07 / $510.95	Professional		$262.19	$361.07	$510.95
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $237.06 / $308.08 / $460.77	Facility		$237.06	$308.08	$460.77
Medical Mutual of Ohio Facility/Professional Facility Modifier 54 Low / Median / High Price $322.54 / $322.54 / $322.54	Facility	54	$322.54	$322.54	$322.54
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $270.80 / $370.82 / $510.76	Professional		$270.80	$370.82	$510.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.53 / $136.92 / $348.73	Professional		$32.53	$136.92	$348.73
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 $218.70 / $337.09 / $556.52	Professional		$218.70	$337.09	$556.52