Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.21 / $1,812.72 / $4,723.00	Facility		$101.21	$1,812.72	$4,723.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $27.66 / $130.81 / $3,324.00	Facility	52	$27.66	$130.81	$3,324.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $11.06 / $35.19 / $106.71	Facility	53	$11.06	$35.19	$106.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.24 / $119.36 / $299.08	Professional		$55.24	$119.36	$299.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.65 / $48.52 / $79.98	Professional		$34.65	$48.52	$79.98
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 $51.46 / $99.09 / $205.49	Professional		$51.46	$99.09	$205.49
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $60.25 / $60.25 / $305.74	Professional		$60.25	$60.25	$305.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $53.32 / $63.98 / $79.98	Facility		$53.32	$63.98	$79.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $167.07 / $217.19 / $373.38	Professional		$167.07	$217.19	$373.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.68 / $225.53 / $581.00	Facility		$95.68	$225.53	$581.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $76.54 / $76.54 / $76.54	Facility	52	$76.54	$76.54	$76.54
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $19.14 / $19.14 / $19.14	Facility	53	$19.14	$19.14	$19.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.32 / $153.00 / $287.99	Professional		$61.32	$153.00	$287.99
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $206.47 / $456.00 / $1,225.50	Facility		$206.47	$456.00	$1,225.50
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $76.54 / $76.54 / $76.54	Facility	52	$76.54	$76.54	$76.54
Medical Mutual of Ohio Facility/Professional Facility Modifier 53 Low / Median / High Price $19.14 / $19.14 / $19.14	Facility	53	$19.14	$19.14	$19.14
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $63.99 / $162.19 / $287.99	Professional		$63.99	$162.19	$287.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $160.59 / $222.35 / $309.63	Professional		$160.59	$222.35	$309.63
United Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $1,396.00 / $3,923.00	Facility		$500.00	$1,396.00	$3,923.00
United Facility/Professional Professional Modifier Low / Median / High Price $131.19 / $192.19 / $339.98	Professional		$131.19	$192.19	$339.98