Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $463.74 / $1,479.87 / $4,707.89	Facility		$463.74	$1,479.87	$4,707.89
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $74.95 / $500.26 / $1,625.38	Facility	52	$74.95	$500.26	$1,625.38
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $29.98 / $200.10 / $650.15	Facility	53	$29.98	$200.10	$650.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.37 / $284.35 / $1,700.39	Professional		$149.37	$284.35	$1,700.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.18 / $153.13 / $221.82	Professional		$100.18	$153.13	$221.82
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
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $153.38 / $228.73 / $1,131.69	Professional		$153.38	$228.73	$1,131.69
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $161.71 / $161.71 / $261.89	Professional		$161.71	$161.71	$261.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $143.11 / $171.73 / $214.67	Facility		$143.11	$171.73	$214.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $911.92 / $1,185.50 / $2,020.43	Professional		$911.92	$1,185.50	$2,020.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $257.77 / $885.00 / $1,309.85	Facility		$257.77	$885.00	$1,309.85
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $206.22 / $206.22 / $206.22	Facility	52	$206.22	$206.22	$206.22
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $51.55 / $51.55 / $51.55	Facility	53	$51.55	$51.55	$51.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.96 / $306.25 / $1,696.91	Professional		$163.96	$306.25	$1,696.91
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $608.99 / $1,199.14 / $2,357.02	Facility		$608.99	$1,199.14	$2,357.02
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $206.22 / $206.22 / $206.22	Facility	52	$206.22	$206.22	$206.22
Medical Mutual of Ohio Facility/Professional Facility Modifier 53 Low / Median / High Price $51.55 / $51.55 / $51.55	Facility	53	$51.55	$51.55	$51.55
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $157.51 / $283.94 / $1,641.44	Professional		$157.51	$283.94	$1,641.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $823.00 / $1,141.08 / $1,590.26	Professional		$823.00	$1,141.08	$1,590.26
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 $195.33 / $1,120.58 / $2,153.88	Professional		$195.33	$1,120.58	$2,153.88