Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $175.97 / $697.73 / $8,956.00	Facility		$175.97	$697.73	$8,956.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $105.20 / $158.29 / $388.81	Facility	54	$105.20	$158.29	$388.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $153.79 / $281.18	Professional		$127.50	$153.79	$281.18
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 $70.26 / $106.06 / $192.68	Professional		$70.26	$106.06	$192.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $128.22 / $139.88 / $203.69	Facility		$128.22	$139.88	$203.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $118.96 / $171.60 / $218.40	Professional		$118.96	$171.60	$218.40
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 $143.99 / $200.64 / $289.97	Professional		$143.99	$200.64	$289.97
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $245.60 / $245.60 / $245.60	Facility		$245.60	$245.60	$245.60
Medical Mutual of Ohio Facility/Professional Facility Modifier 54 Low / Median / High Price $171.92 / $171.92 / $171.92	Facility	54	$171.92	$171.92	$171.92
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $150.85 / $204.45 / $289.97	Professional		$150.85	$204.45	$289.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.41 / $122.30 / $200.99	Professional		$32.41	$122.30	$200.99
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 $125.69 / $191.84 / $321.37	Professional		$125.69	$191.84	$321.37