Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $368.07 / $793.36 / $8,553.00	Facility		$368.07	$793.36	$8,553.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $239.24 / $355.75 / $824.36	Facility	54	$239.24	$355.75	$824.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.17 / $342.64 / $649.98	Professional		$288.17	$342.64	$649.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $412.88 / $412.88 / $412.88	Professional		$412.88	$412.88	$412.88
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 $232.43 / $320.70 / $516.14	Professional		$232.43	$320.70	$516.14
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $392.91 / $392.91 / $392.91	Professional		$392.91	$392.91	$392.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $291.95 / $374.70 / $497.66	Facility		$291.95	$374.70	$497.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $369.40 / $470.15 / $127,498.73	Professional		$369.40	$470.15	$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 $319.81 / $443.21 / $635.29	Professional		$319.81	$443.21	$635.29
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $303.64 / $409.93 / $557.42	Facility		$303.64	$409.93	$557.42
Medical Mutual of Ohio Facility/Professional Facility Modifier 54 Low / Median / High Price $390.20 / $390.20 / $390.20	Facility	54	$390.20	$390.20	$390.20
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $327.86 / $452.76 / $632.85	Professional		$327.86	$452.76	$632.85
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 / $965.00 / $2,914.00	Facility		$444.00	$965.00	$2,914.00
United Facility/Professional Professional Modifier Low / Median / High Price $275.62 / $416.13 / $694.42	Professional		$275.62	$416.13	$694.42