Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $407.71 / $1,568.97 / $4,570.84	Facility		$407.71	$1,568.97	$4,570.84
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $59.84 / $157.27 / $436.00	Facility	52	$59.84	$157.27	$436.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $23.93 / $60.35 / $168.11	Facility	53	$23.93	$60.35	$168.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.28 / $239.88 / $518.48	Professional		$119.28	$239.88	$518.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $65.92 / $133.35 / $171.96	Professional		$65.92	$133.35	$171.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $777.00 / $1,931.00 / $3,943.00	Facility		$777.00	$1,931.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.68 / $272.74 / $455.63	Professional		$136.68	$272.74	$455.63
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $129.54 / $129.54 / $129.54	Professional		$129.54	$129.54	$129.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $114.64 / $137.57 / $171.96	Facility		$114.64	$137.57	$171.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $258.74 / $336.36 / $583.25	Professional		$258.74	$336.36	$583.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $206.39 / $577.00 / $839.11	Facility		$206.39	$577.00	$839.11
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $165.11 / $165.11 / $165.11	Facility	52	$165.11	$165.11	$165.11
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $41.28 / $41.28 / $41.28	Facility	53	$41.28	$41.28	$41.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.13 / $268.47 / $491.69	Professional		$134.13	$268.47	$491.69
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $456.00 / $1,072.97 / $2,302.69	Facility		$456.00	$1,072.97	$2,302.69
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $165.11 / $165.11 / $165.11	Facility	52	$165.11	$165.11	$165.11
Medical Mutual of Ohio Facility/Professional Facility Modifier 53 Low / Median / High Price $41.28 / $41.28 / $41.28	Facility	53	$41.28	$41.28	$41.28
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $123.32 / $239.79 / $473.35	Professional		$123.32	$239.79	$473.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $298.85 / $416.35	Professional		$216.90	$298.85	$416.35
United Facility/Professional Facility Modifier Low / Median / High Price $675.00 / $2,499.00 / $5,235.00	Facility		$675.00	$2,499.00	$5,235.00
United Facility/Professional Professional Modifier Low / Median / High Price $235.66 / $325.44 / $550.22	Professional		$235.66	$325.44	$550.22