Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $350.42 / $1,451.00 / $8,853.20	Facility		$350.42	$1,451.00	$8,853.20
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $97.69 / $232.50 / $638.38	Facility	52	$97.69	$232.50	$638.38
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $39.08 / $93.00 / $255.35	Facility	53	$39.08	$93.00	$255.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.38 / $404.66 / $724.98	Professional		$195.38	$404.66	$724.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.42 / $122.02 / $225.28	Professional		$85.42	$122.02	$225.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $919.00 / $2,707.00 / $8,015.00	Facility		$919.00	$2,707.00	$8,015.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $196.27 / $252.91 / $428.67	Professional		$196.27	$252.91	$428.67
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $212.13 / $212.13 / $212.13	Professional		$212.13	$212.13	$212.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $187.73 / $225.28 / $281.60	Facility		$187.73	$225.28	$281.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $397.25 / $516.42 / $898.39	Professional		$397.25	$516.42	$898.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.16 / $763.40 / $959.43	Facility		$338.16	$763.40	$959.43
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $270.52 / $270.52 / $270.52	Facility	52	$270.52	$270.52	$270.52
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $67.63 / $67.63 / $67.63	Facility	53	$67.63	$67.63	$67.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $215.89 / $406.38 / $729.56	Professional		$215.89	$406.38	$729.56
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $508.00 / $885.00 / $1,949.75	Facility		$508.00	$885.00	$1,949.75
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $270.52 / $270.52 / $270.52	Facility	52	$270.52	$270.52	$270.52
Medical Mutual of Ohio Facility/Professional Facility Modifier 53 Low / Median / High Price $67.63 / $67.63 / $67.63	Facility	53	$67.63	$67.63	$67.63
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $187.73 / $382.97 / $718.24	Professional		$187.73	$382.97	$718.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $355.60 / $488.31 / $673.17	Professional		$355.60	$488.31	$673.17
United Facility/Professional Facility Modifier Low / Median / High Price $707.00 / $2,551.00 / $5,457.00	Facility		$707.00	$2,551.00	$5,457.00
United Facility/Professional Professional Modifier Low / Median / High Price $361.20 / $519.88 / $836.98	Professional		$361.20	$519.88	$836.98