Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $476.13 / $1,849.00 / $5,749.62	Facility		$476.13	$1,849.00	$5,749.62
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $67.64 / $230.77 / $3,690.64	Facility	52	$67.64	$230.77	$3,690.64
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $27.06 / $75.55 / $224.20	Facility	53	$27.06	$75.55	$224.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.61 / $271.52 / $672.45	Professional		$101.61	$271.52	$672.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.42 / $126.15 / $199.70	Professional		$64.42	$126.15	$199.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $777.00 / $1,944.00 / $3,943.00	Facility		$777.00	$1,944.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.11 / $304.92 / $518.46	Professional		$162.11	$304.92	$518.46
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $141.72 / $145.59 / $235.78	Professional		$141.72	$145.59	$235.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $128.84 / $154.61 / $193.26	Facility		$128.84	$154.61	$193.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $333.35 / $433.36 / $748.68	Professional		$333.35	$433.36	$748.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $232.12 / $611.00 / $885.00	Facility		$232.12	$611.00	$885.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $185.70 / $185.70 / $185.70	Facility	52	$185.70	$185.70	$185.70
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $46.42 / $46.42 / $46.42	Facility	53	$46.42	$46.42	$46.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $150.75 / $325.00 / $617.61	Professional		$150.75	$325.00	$617.61
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $608.29 / $1,171.19 / $2,766.97	Facility		$608.29	$1,171.19	$2,766.97
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $185.70 / $185.70 / $185.70	Facility	52	$185.70	$185.70	$185.70
Medical Mutual of Ohio Facility/Professional Facility Modifier 53 Low / Median / High Price $46.42 / $46.42 / $46.42	Facility	53	$46.42	$46.42	$46.42
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $98.31 / $236.18 / $550.02	Professional		$98.31	$236.18	$550.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $272.03 / $372.10 / $517.81	Professional		$272.03	$372.10	$517.81
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 $230.18 / $392.73 / $681.86	Professional		$230.18	$392.73	$681.86