Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $166.82 / $1,602.11 / $9,504.00	Facility		$166.82	$1,602.11	$9,504.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $56.81 / $96.07 / $269.62	Facility	52	$56.81	$96.07	$269.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.62 / $166.82 / $330.21	Professional		$113.62	$166.82	$330.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,051.00 / $2,012.00 / $3,943.00	Facility		$1,051.00	$2,012.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.40 / $172.39 / $306.49	Professional		$116.40	$172.39	$306.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $108.83 / $130.60 / $161.63	Facility		$108.83	$130.60	$161.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $172.88 / $172.88 / $175.50	Professional		$172.88	$172.88	$175.50
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 $127.33 / $200.52 / $336.68	Professional		$127.33	$200.52	$336.68
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $767.80 / $767.80 / $767.80	Facility		$767.80	$767.80	$767.80
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $134.16 / $204.31 / $341.40	Professional		$134.16	$204.31	$341.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $143.14 / $194.73 / $260.38	Professional		$143.14	$194.73	$260.38
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $979.00 / $3,218.00	Facility		$444.00	$979.00	$3,218.00
United Facility/Professional Professional Modifier Low / Median / High Price $155.06 / $212.73 / $359.86	Professional		$155.06	$212.73	$359.86