Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $193.20 / $1,778.00 / $4,842.77	Facility		$193.20	$1,778.00	$4,842.77
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $35.29 / $200.34 / $2,606.02	Facility	52	$35.29	$200.34	$2,606.02
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $14.11 / $53.89 / $165.78	Facility	53	$14.11	$53.89	$165.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.56 / $152.38 / $458.08	Professional		$70.56	$152.38	$458.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.75 / $83.23 / $105.18	Professional		$61.75	$83.23	$105.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $777.00 / $1,765.00 / $3,943.00	Facility		$777.00	$1,765.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.54 / $125.09 / $292.01	Professional		$69.54	$125.09	$292.01
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $76.68 / $76.68 / $76.68	Professional		$76.68	$76.68	$76.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $67.86 / $81.43 / $101.79	Facility		$67.86	$81.43	$101.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $251.74 / $327.26 / $561.14	Professional		$251.74	$327.26	$561.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $121.96 / $554.95 / $741.93	Facility		$121.96	$554.95	$741.93
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $97.57 / $97.57 / $97.57	Facility	52	$97.57	$97.57	$97.57
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $24.39 / $24.39 / $24.39	Facility	53	$24.39	$24.39	$24.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.34 / $196.18 / $436.22	Professional		$76.34	$196.18	$436.22
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $400.00 / $619.07 / $1,121.00	Facility		$400.00	$619.07	$1,121.00
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $97.57 / $97.57 / $97.57	Facility	52	$97.57	$97.57	$97.57
Medical Mutual of Ohio Facility/Professional Facility Modifier 53 Low / Median / High Price $24.39 / $24.39 / $24.39	Facility	53	$24.39	$24.39	$24.39
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $78.04 / $209.72 / $439.12	Professional		$78.04	$209.72	$439.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $212.96 / $295.57 / $411.09	Professional		$212.96	$295.57	$411.09
United Facility/Professional Facility Modifier Low / Median / High Price $487.00 / $1,848.00 / $4,067.00	Facility		$487.00	$1,848.00	$4,067.00
United Facility/Professional Professional Modifier Low / Median / High Price $178.54 / $296.83 / $533.00	Professional		$178.54	$296.83	$533.00