Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.25 / $2,936.00 / $6,582.00	Facility		$245.25	$2,936.00	$6,582.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $65.09 / $124.00 / $395.27	Facility	52	$65.09	$124.00	$395.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.35 / $245.26 / $533.10	Professional		$117.35	$245.26	$533.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.70 / $143.31 / $162.01	Professional		$56.70	$143.31	$162.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,145.00 / $2,792.00 / $8,800.00	Facility		$1,145.00	$2,792.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.72 / $263.58 / $457.08	Professional		$144.72	$263.58	$457.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $124.62 / $155.78 / $185.09	Facility		$124.62	$155.78	$185.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $257.35 / $304.14 / $530.24	Professional		$257.35	$304.14	$530.24
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 $149.55 / $268.37 / $474.71	Professional		$149.55	$268.37	$474.71
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $835.58 / $2,155.60 / $4,938.66	Facility		$835.58	$2,155.60	$4,938.66
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $152.04 / $269.04 / $474.71	Professional		$152.04	$269.04	$474.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $228.49 / $310.54 / $419.30	Professional		$228.49	$310.54	$419.30
United Facility/Professional Facility Modifier Low / Median / High Price $1,725.00 / $2,721.00 / $5,235.00	Facility		$1,725.00	$2,721.00	$5,235.00
United Facility/Professional Professional Modifier Low / Median / High Price $233.34 / $324.61 / $526.12	Professional		$233.34	$324.61	$526.12