Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $226.64 / $741.84 / $9,504.00	Facility		$226.64	$741.84	$9,504.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $140.43 / $208.82 / $507.46	Facility	54	$140.43	$208.82	$507.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.11 / $206.04 / $368.86	Professional		$169.11	$206.04	$368.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $188.67 / $191.92 / $191.92	Professional		$188.67	$191.92	$191.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $814.00 / $1,927.00 / $3,943.00	Facility		$814.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.50 / $139.62 / $259.70	Professional		$92.50	$139.62	$259.70
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $222.22 / $242.42 / $242.42	Professional		$222.22	$242.42	$242.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $171.81 / $187.43 / $272.92	Facility		$171.81	$187.43	$272.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $170.14 / $222.22 / $282.83	Professional		$170.14	$222.22	$282.83
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 $192.94 / $269.61 / $386.73	Professional		$192.94	$269.61	$386.73
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $328.64 / $328.64 / $649.52	Facility		$328.64	$328.64	$649.52
Medical Mutual of Ohio Facility/Professional Facility Modifier 54 Low / Median / High Price $230.05 / $230.05 / $230.05	Facility	54	$230.05	$230.05	$230.05
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $194.83 / $275.24 / $387.36	Professional		$194.83	$275.24	$387.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.41 / $155.39 / $245.56	Professional		$32.41	$155.39	$245.56
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 $168.68 / $258.14 / $432.89	Professional		$168.68	$258.14	$432.89