Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $391.69 / $1,902.00 / $9,504.00	Facility		$391.69	$1,902.00	$9,504.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $57.34 / $230.56 / $836.52	Facility	52	$57.34	$230.56	$836.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.68 / $230.15 / $726.00	Professional		$114.68	$230.15	$726.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $918.00 / $2,386.00 / $8,800.00	Facility		$918.00	$2,386.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.38 / $204.03 / $532.53	Professional		$131.38	$204.03	$532.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $109.55 / $131.46 / $162.71	Facility		$109.55	$131.46	$162.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $136.94 / $468.63 / $553.84	Professional		$136.94	$468.63	$553.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $197.32 / $577.00 / $1,287.90	Facility		$197.32	$577.00	$1,287.90
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $157.86 / $157.86 / $157.86	Facility	52	$157.86	$157.86	$157.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.98 / $251.90 / $803.43	Professional		$125.98	$251.90	$803.43
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $366.00 / $577.00 / $959.43	Facility		$366.00	$577.00	$959.43
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $157.86 / $157.86 / $157.86	Facility	52	$157.86	$157.86	$157.86
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $131.46 / $260.00 / $788.52	Professional		$131.46	$260.00	$788.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $390.30 / $519.07 / $724.08	Professional		$390.30	$519.07	$724.08
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 $179.19 / $546.45 / $1,031.81	Professional		$179.19	$546.45	$1,031.81