Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $424.81 / $7,234.00 / $11,627.00	Facility		$424.81	$7,234.00	$11,627.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $130.65 / $623.97 / $1,965.07	Facility	52	$130.65	$623.97	$1,965.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $226.06 / $514.74 / $2,121.48	Professional		$226.06	$514.74	$2,121.48
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $130.65 / $522.00 / $927.84	Professional	52	$130.65	$522.00	$927.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $2,722.48 / $2,722.48 / $2,722.48	Professional		$2,722.48	$2,722.48	$2,722.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,895.00 / $5,945.00 / $29,406.00	Facility		$1,895.00	$5,945.00	$29,406.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $214.25 / $829.55 / $1,692.41	Professional		$214.25	$829.55	$1,692.41
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $252.30 / $252.30 / $252.30	Professional		$252.30	$252.30	$252.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $227.74 / $227.74 / $331.62	Facility		$227.74	$227.74	$331.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,133.76 / $1,133.76 / $1,367.14	Professional		$1,133.76	$1,133.76	$1,367.14
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 $255.11 / $490.76 / $1,873.23	Professional		$255.11	$490.76	$1,873.23
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $256.77 / $472.21 / $1,860.02	Professional		$256.77	$472.21	$1,860.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $981.47 / $1,301.09 / $1,765.75	Professional		$981.47	$1,301.09	$1,765.75
United Facility/Professional Facility Modifier Low / Median / High Price $4,070.00 / $8,448.00 / $13,382.00	Facility		$4,070.00	$8,448.00	$13,382.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,209.27 / $1,604.97 / $2,512.29	Professional		$1,209.27	$1,604.97	$2,512.29