Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.03 / $777.75 / $5,135.00	Facility		$68.03	$777.75	$5,135.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $18.59 / $105.97 / $343.07	Facility	52	$18.59	$105.97	$343.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.07 / $186.49 / $362.74	Professional		$35.07	$186.49	$362.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.48 / $64.36 / $85.80	Professional		$46.48	$64.36	$85.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $711.00 / $1,750.00 / $3,943.00	Facility		$711.00	$1,750.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.15 / $138.12 / $315.67	Professional		$36.15	$138.12	$315.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $35.75 / $42.90 / $53.10	Facility		$35.75	$42.90	$53.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $44.69 / $215.99 / $255.26	Professional		$44.69	$215.99	$255.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.27 / $265.94 / $600.00	Facility		$64.27	$265.94	$600.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $51.42 / $51.42 / $51.42	Facility	52	$51.42	$51.42	$51.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.12 / $208.00 / $383.87	Professional		$41.12	$208.00	$383.87
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $157.63 / $433.57 / $770.83	Facility		$157.63	$433.57	$770.83
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $51.42 / $51.42 / $51.42	Facility	52	$51.42	$51.42	$51.42
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $42.91 / $211.12 / $390.64	Professional		$42.91	$211.12	$390.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $190.23 / $259.06 / $360.36	Professional		$190.23	$259.06	$360.36
United Facility/Professional Facility Modifier Low / Median / High Price $123.00 / $881.00 / $3,398.00	Facility		$123.00	$881.00	$3,398.00
United Facility/Professional Professional Modifier Low / Median / High Price $187.23 / $267.70 / $438.12	Professional		$187.23	$267.70	$438.12