Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $609.00 / $2,849.00 / $9,504.00	Facility		$609.00	$2,849.00	$9,504.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $98.08 / $145.84 / $334.83	Facility	52	$98.08	$145.84	$334.83
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $39.22 / $58.34 / $133.93	Facility	53	$39.22	$58.34	$133.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $918.00 / $2,443.00 / $8,800.00	Facility		$918.00	$2,443.00	$8,800.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $187.46 / $224.95 / $278.42	Facility		$187.46	$224.95	$278.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $225.67 / $885.00 / $1,758.30	Facility		$225.67	$885.00	$1,758.30
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $176.57 / $176.57 / $176.57	Facility	52	$176.57	$176.57	$176.57
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $44.14 / $44.14 / $44.14	Facility	53	$44.14	$44.14	$44.14
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $137.94 / $137.94 / $137.94	Facility	62	$137.94	$137.94	$137.94
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $22.07 / $22.07 / $22.07	Facility	AS	$22.07	$22.07	$22.07
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $491.00 / $885.00 / $1,758.30	Facility		$491.00	$885.00	$1,758.30
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $176.57 / $176.57 / $176.57	Facility	52	$176.57	$176.57	$176.57
Medical Mutual of Ohio Facility/Professional Facility Modifier 53 Low / Median / High Price $44.14 / $44.14 / $44.14	Facility	53	$44.14	$44.14	$44.14
Medical Mutual of Ohio Facility/Professional Facility Modifier 62 Low / Median / High Price $137.94 / $137.94 / $137.94	Facility	62	$137.94	$137.94	$137.94
Medical Mutual of Ohio Facility/Professional Facility Modifier AS Low / Median / High Price $22.07 / $22.07 / $22.07	Facility	AS	$22.07	$22.07	$22.07
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