Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $488.33 / $1,684.28 / $9,504.00	Facility		$488.33	$1,684.28	$9,504.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $366.25 / $544.61 / $1,263.21	Facility	54	$366.25	$544.61	$1,263.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $449.58 / $514.71 / $925.65	Professional		$449.58	$514.71	$925.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $479.35 / $479.35 / $479.35	Professional		$479.35	$479.35	$479.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,981.00 / $3,943.00	Facility		$937.00	$1,981.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $366.17 / $504.47 / $818.50	Professional		$366.17	$504.47	$818.50
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $555.04 / $574.38 / $605.50	Professional		$555.04	$574.38	$605.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $447.54 / $574.38 / $762.86	Facility		$447.54	$574.38	$762.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $555.04 / $706.41 / $127,498.73	Professional		$555.04	$706.41	$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 $498.91 / $689.00 / $982.98	Professional		$498.91	$689.00	$982.98
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $855.54 / $855.54 / $855.54	Facility		$855.54	$855.54	$855.54
Medical Mutual of Ohio Facility/Professional Facility Modifier 54 Low / Median / High Price $598.88 / $598.88 / $598.88	Facility	54	$598.88	$598.88	$598.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $502.58 / $698.48 / $979.00	Professional		$502.58	$698.48	$979.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $71.16 / $367.39 / $629.22	Professional		$71.16	$367.39	$629.22
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 $419.33 / $644.42 / $1,061.33	Professional		$419.33	$644.42	$1,061.33