Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $1,819.70 / $4,786.30	Facility		$363.08	$1,819.70	$4,786.30
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $954.99 / $1,412.54 / $1,905.46	Facility	52	$954.99	$1,412.54	$1,905.46
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $3,890.45 / $3,890.45 / $3,890.45	Facility	53	$3,890.45	$3,890.45	$3,890.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $251.19 / $691.83	Professional		$112.20	$251.19	$691.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $125.89 / $173.78	Professional		$66.07	$125.89	$173.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,238.72 / $4,073.80	Facility		$707.95	$2,238.72	$4,073.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $281.84 / $457.09	Professional		$138.04	$281.84	$457.09
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $194.98 / $218.78	Professional		$128.82	$194.98	$218.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $147.91 / $194.98	Facility		$117.49	$147.91	$194.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $338.84 / $616.60	Professional		$257.04	$338.84	$616.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $380.19 / $1,318.26	Facility		$173.78	$380.19	$1,318.26
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $245.47 / $245.47 / $245.47	Facility	22	$245.47	$245.47	$245.47
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $165.96 / $165.96 / $165.96	Facility	52	$165.96	$165.96	$165.96
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $41.69 / $41.69 / $41.69	Facility	53	$41.69	$41.69	$41.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $275.42 / $524.81	Professional		$134.90	$275.42	$524.81
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $1,202.26 / $3,235.94	Facility		$398.11	$1,202.26	$3,235.94
Medical Mutual of Ohio Facility/Professional Facility Modifier 22 Low / Median / High Price $245.47 / $245.47 / $245.47	Facility	22	$245.47	$245.47	$245.47
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $165.96 / $165.96 / $165.96	Facility	52	$165.96	$165.96	$165.96
Medical Mutual of Ohio Facility/Professional Facility Modifier 53 Low / Median / High Price $41.69 / $41.69 / $41.69	Facility	53	$41.69	$41.69	$41.69
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $223.87 / $467.74	Professional		$109.65	$223.87	$467.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $138.04	Professional		$32.36	$33.11	$138.04
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $416.87 / $1,122.02	Facility		$100.00	$416.87	$1,122.02
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $309.03 / $602.56	Professional		$117.49	$309.03	$602.56
United Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $2,398.83 / $4,897.79	Facility		$676.08	$2,398.83	$4,897.79
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $229.09 / $426.58	Professional		$114.82	$229.09	$426.58