Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $501.75 / $2,400.00 / $6,108.12	Facility		$501.75	$2,400.00	$6,108.12
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $29.78 / $157.96 / $303.39	Facility	53	$29.78	$157.96	$303.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $148.88 / $394.13 / $1,421.62	Professional		$148.88	$394.13	$1,421.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $277.02 / $277.02 / $277.02	Professional		$277.02	$277.02	$277.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,145.00 / $2,786.00 / $8,800.00	Facility		$1,145.00	$2,786.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.58 / $580.97 / $1,300.23	Professional		$146.58	$580.97	$1,300.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $142.06 / $177.58 / $211.00	Facility		$142.06	$177.58	$211.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $805.53 / $951.99 / $1,627.37	Professional		$805.53	$951.99	$1,627.37
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 $170.47 / $354.00 / $1,397.31	Professional		$170.47	$354.00	$1,397.31
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $416.59 / $1,110.39 / $6,864.30	Facility		$416.59	$1,110.39	$6,864.30
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $177.57 / $381.90 / $1,455.69	Professional		$177.57	$381.90	$1,455.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $669.32 / $904.16 / $1,274.55	Professional		$669.32	$904.16	$1,274.55
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $2,665.00 / $5,268.00	Facility		$1,689.00	$2,665.00	$5,268.00
United Facility/Professional Professional Modifier Low / Median / High Price $844.80 / $1,210.16 / $1,987.56	Professional		$844.80	$1,210.16	$1,987.56