Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $366.45 / $2,233.83 / $5,135.00	Facility		$366.45	$2,233.83	$5,135.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $86.26 / $201.55 / $567.26	Facility	52	$86.26	$201.55	$567.26
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $34.50 / $80.62 / $226.90	Facility	53	$34.50	$80.62	$226.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.52 / $327.27 / $623.65	Professional		$172.52	$327.27	$623.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.63 / $197.58 / $255.21	Professional		$82.63	$197.58	$255.21
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 $174.52 / $251.77 / $476.69	Professional		$174.52	$251.77	$476.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $164.65 / $197.58 / $244.55	Facility		$164.65	$197.58	$244.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $205.81 / $378.84 / $447.72	Professional		$205.81	$378.84	$447.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $296.61 / $611.00 / $885.00	Facility		$296.61	$611.00	$885.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $237.29 / $237.29 / $237.29	Facility	52	$237.29	$237.29	$237.29
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $59.32 / $59.32 / $59.32	Facility	53	$59.32	$59.32	$59.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $187.85 / $333.86 / $632.37	Professional		$187.85	$333.86	$632.37
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $508.00 / $767.58 / $2,094.19	Facility		$508.00	$767.58	$2,094.19
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $237.29 / $237.29 / $237.29	Facility	52	$237.29	$237.29	$237.29
Medical Mutual of Ohio Facility/Professional Facility Modifier 53 Low / Median / High Price $59.32 / $59.32 / $59.32	Facility	53	$59.32	$59.32	$59.32
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $192.64 / $333.86 / $625.70	Professional		$192.64	$333.86	$625.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $299.29 / $411.81 / $572.15	Professional		$299.29	$411.81	$572.15
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 $226.37 / $392.91 / $731.29	Professional		$226.37	$392.91	$731.29