Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $525.69 / $1,902.00 / $9,534.00	Facility		$525.69	$1,902.00	$9,534.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $361.29 / $537.24 / $1,292.31	Facility	54	$361.29	$537.24	$1,292.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $444.68 / $515.79 / $903.78	Professional		$444.68	$515.79	$903.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,145.00 / $2,722.00 / $8,800.00	Facility		$1,145.00	$2,722.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $390.46 / $529.46 / $843.01	Professional		$390.46	$529.46	$843.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $440.35 / $565.16 / $750.62	Facility		$440.35	$565.16	$750.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $565.07 / $719.18 / $127,498.73	Professional		$565.07	$719.18	$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 $494.52 / $682.91 / $979.76	Professional		$494.52	$682.91	$979.76
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $842.02 / $842.02 / $842.02	Facility		$842.02	$842.02	$842.02
Medical Mutual of Ohio Facility/Professional Facility Modifier 54 Low / Median / High Price $589.41 / $589.41 / $589.41	Facility	54	$589.41	$589.41	$589.41
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $494.52 / $695.15 / $974.06	Professional		$494.52	$695.15	$974.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $71.16 / $367.62 / $629.22	Professional		$71.16	$367.62	$629.22
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $2,600.00 / $5,235.00	Facility		$1,689.00	$2,600.00	$5,235.00
United Facility/Professional Professional Modifier Low / Median / High Price $429.20 / $652.28 / $1,095.15	Professional		$429.20	$652.28	$1,095.15