Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $966.20 / $3,785.00 / $8,976.46	Facility		$966.20	$3,785.00	$8,976.46
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $5,542.00 / $5,542.00 / $5,542.00	Facility	22	$5,542.00	$5,542.00	$5,542.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $500.02 / $621.82 / $1,244.58	Professional		$500.02	$621.82	$1,244.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $282.26 / $508.00 / $790.33	Professional		$282.26	$508.00	$790.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,760.00 / $4,748.00 / $14,996.00	Facility		$1,760.00	$4,748.00	$14,996.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $509.93 / $690.41 / $1,096.36	Professional		$509.93	$690.41	$1,096.36
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $637.91 / $660.49 / $739.52	Professional		$637.91	$660.49	$739.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $564.52 / $677.42 / $846.78	Facility		$564.52	$677.42	$846.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $594.13 / $733.88 / $1,100.82	Professional		$594.13	$733.88	$1,100.82
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 $592.74 / $824.38 / $1,179.79	Professional		$592.74	$824.38	$1,179.79
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,190.59 / $1,927.51 / $5,076.66	Facility		$1,190.59	$1,927.51	$5,076.66
Medical Mutual of Ohio Facility/Professional Facility Modifier AS Low / Median / High Price $67.26 / $67.26 / $67.26	Facility	AS	$67.26	$67.26	$67.26
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $220.47 / $790.32 / $1,166.44	Professional		$220.47	$790.32	$1,166.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $72.37 / $422.84 / $730.19	Professional		$72.37	$422.84	$730.19
United Facility/Professional Facility Modifier Low / Median / High Price $4,227.00 / $8,440.00 / $13,676.00	Facility		$4,227.00	$8,440.00	$13,676.00
United Facility/Professional Professional Modifier Low / Median / High Price $500.50 / $762.10 / $1,247.10	Professional		$500.50	$762.10	$1,247.10