Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $467.82 / $1,361.78 / $8,956.00	Facility		$467.82	$1,361.78	$8,956.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $316.98 / $471.35 / $1,124.45	Facility	54	$316.98	$471.35	$1,124.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $393.50 / $467.82 / $813.35	Professional		$393.50	$467.82	$813.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $694.23 / $694.23 / $694.23	Professional		$694.23	$694.23	$694.23
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 $339.69 / $467.57 / $733.39	Professional		$339.69	$467.57	$733.39
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $495.88 / $495.88 / $495.88	Professional		$495.88	$495.88	$495.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $386.38 / $495.88 / $658.59	Facility		$386.38	$495.88	$658.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $503.17 / $640.40 / $127,498.73	Professional		$503.17	$640.40	$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 $433.89 / $599.17 / $856.93	Professional		$433.89	$599.17	$856.93
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $738.59 / $738.59 / $784.10	Facility		$738.59	$738.59	$784.10
Medical Mutual of Ohio Facility/Professional Facility Modifier 54 Low / Median / High Price $517.01 / $517.01 / $517.01	Facility	54	$517.01	$517.01	$517.01
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $433.89 / $611.94 / $857.47	Professional		$433.89	$611.94	$857.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $71.16 / $354.70 / $569.58	Professional		$71.16	$354.70	$569.58
United Facility/Professional Facility Modifier Low / Median / High Price $1,020.00 / $1,940.00 / $4,067.00	Facility		$1,020.00	$1,940.00	$4,067.00
United Facility/Professional Professional Modifier Low / Median / High Price $378.85 / $559.73 / $929.15	Professional		$378.85	$559.73	$929.15