Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $296.98 / $1,719.93 / $3,696.00	Facility		$296.98	$1,719.93	$3,696.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,456.24 / $5,456.24 / $5,456.24	Facility	50	$5,456.24	$5,456.24	$5,456.24
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $53.38 / $151.37 / $469.02	Facility	52	$53.38	$151.37	$469.02
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $21.35 / $60.55 / $187.61	Facility	53	$21.35	$60.55	$187.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.75 / $202.50 / $588.49	Professional		$106.75	$202.50	$588.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $92.78 / $123.61 / $158.02	Professional		$92.78	$123.61	$158.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,927.00 / $3,943.00	Facility		$937.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.41 / $309.32 / $777.07	Professional		$101.41	$309.32	$777.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $101.95 / $127.44 / $151.41	Facility		$101.95	$127.44	$151.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $305.99 / $361.62 / $625.00	Professional		$305.99	$361.62	$625.00
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 $122.35 / $252.57 / $668.71	Professional		$122.35	$252.57	$668.71
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $910.49 / $1,551.30 / $3,571.54	Facility		$910.49	$1,551.30	$3,571.54
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $127.44 / $254.60 / $639.79	Professional		$127.44	$254.60	$639.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $254.02 / $344.12 / $473.71	Professional		$254.02	$344.12	$473.71
United Facility/Professional Facility Modifier Low / Median / High Price $1,020.00 / $1,952.00 / $4,132.00	Facility		$1,020.00	$1,952.00	$4,132.00
United Facility/Professional Professional Modifier Low / Median / High Price $278.08 / $430.15 / $873.22	Professional		$278.08	$430.15	$873.22