Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $411.00 / $1,679.00 / $9,504.00	Facility		$411.00	$1,679.00	$9,504.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $284.87 / $423.59 / $1,014.73	Facility	54	$284.87	$423.59	$1,014.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.39 / $418.64 / $819.03	Professional		$354.39	$418.64	$819.03
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 $292.95 / $409.06 / $650.36	Professional		$292.95	$409.06	$650.36
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $445.99 / $445.99 / $445.99	Professional		$445.99	$445.99	$445.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $347.50 / $445.99 / $592.34	Facility		$347.50	$445.99	$592.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $450.64 / $573.54 / $127,498.73	Professional		$450.64	$573.54	$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 $384.99 / $542.77 / $782.03	Professional		$384.99	$542.77	$782.03
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $664.33 / $664.33 / $664.33	Facility		$664.33	$664.33	$664.33
Medical Mutual of Ohio Facility/Professional Facility Modifier 54 Low / Median / High Price $465.03 / $465.03 / $465.03	Facility	54	$465.03	$465.03	$465.03
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $390.24 / $553.05 / $778.38	Professional		$390.24	$553.05	$778.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.85 / $305.57 / $538.73	Professional		$34.85	$305.57	$538.73
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 $341.02 / $514.85 / $855.51	Professional		$341.02	$514.85	$855.51