Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $313.18 / $895.44 / $8,956.00	Facility		$313.18	$895.44	$8,956.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $213.53 / $317.52 / $718.28	Facility	54	$213.53	$317.52	$718.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $278.64 / $338.49 / $640.99	Professional		$278.64	$338.49	$640.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $275.61 / $296.99 / $460.33	Professional		$275.61	$296.99	$460.33
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 $264.64 / $351.73 / $572.46	Professional		$264.64	$351.73	$572.46
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $356.39 / $356.39 / $356.39	Professional		$356.39	$356.39	$356.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $261.43 / $335.52 / $445.62	Facility		$261.43	$335.52	$445.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $326.69 / $415.79 / $127,498.73	Professional		$326.69	$415.79	$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 $293.19 / $415.69 / $578.02	Professional		$293.19	$415.69	$578.02
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $157.00 / $332.49 / $498.64	Facility		$157.00	$332.49	$498.64
Medical Mutual of Ohio Facility/Professional Facility Modifier 54 Low / Median / High Price $349.05 / $349.05 / $349.05	Facility	54	$349.05	$349.05	$349.05
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $293.58 / $419.98 / $597.97	Professional		$293.58	$419.98	$597.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.56 / $173.49 / $420.90	Professional		$32.56	$173.49	$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 $251.18 / $395.00 / $593.40	Professional		$251.18	$395.00	$593.40