Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $296.75 / $1,829.50 / $5,722.08	Facility		$296.75	$1,829.50	$5,722.08
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $81.08 / $216.27 / $581.04	Facility	52	$81.08	$216.27	$581.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.16 / $309.26 / $673.62	Professional		$162.16	$309.26	$673.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.29 / $180.75 / $241.46	Professional		$104.29	$180.75	$241.46
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 $164.06 / $237.03 / $485.53	Professional		$164.06	$237.03	$485.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $154.78 / $185.74 / $232.17	Facility		$154.78	$185.74	$232.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $367.83 / $478.18 / $828.31	Professional		$367.83	$478.18	$828.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $278.89 / $611.00 / $885.00	Facility		$278.89	$611.00	$885.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $223.11 / $223.11 / $223.11	Facility	52	$223.11	$223.11	$223.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.41 / $319.62 / $664.23	Professional		$177.41	$319.62	$664.23
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $530.00 / $698.53 / $1,945.45	Facility		$530.00	$698.53	$1,945.45
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $223.11 / $223.11 / $223.11	Facility	52	$223.11	$223.11	$223.11
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $167.69 / $312.66 / $643.35	Professional		$167.69	$312.66	$643.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $325.36 / $448.28 / $624.53	Professional		$325.36	$448.28	$624.53
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 $209.04 / $411.21 / $820.12	Professional		$209.04	$411.21	$820.12