Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $464.21 / $2,664.00 / $9,504.00	Facility		$464.21	$2,664.00	$9,504.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $126.03 / $346.86 / $1,112.15	Facility	52	$126.03	$346.86	$1,112.15
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $50.41 / $138.75 / $444.86	Facility	53	$50.41	$138.75	$444.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $252.06 / $563.69 / $1,071.35	Professional		$252.06	$563.69	$1,071.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $219.36 / $219.36 / $376.04	Professional		$219.36	$219.36	$376.04
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 $266.10 / $355.75 / $617.75	Professional		$266.10	$355.75	$617.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $241.05 / $289.26 / $358.02	Facility		$241.05	$289.26	$358.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $301.31 / $645.38 / $762.72	Professional		$301.31	$645.38	$762.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $434.63 / $763.40 / $959.43	Facility		$434.63	$763.40	$959.43
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $347.70 / $347.70 / $347.70	Facility	52	$347.70	$347.70	$347.70
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $86.93 / $86.93 / $86.93	Facility	53	$86.93	$86.93	$86.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $272.33 / $565.07 / $1,093.09	Professional		$272.33	$565.07	$1,093.09
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $491.00 / $763.40 / $959.43	Facility		$491.00	$763.40	$959.43
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $347.70 / $347.70 / $347.70	Facility	52	$347.70	$347.70	$347.70
Medical Mutual of Ohio Facility/Professional Facility Modifier 53 Low / Median / High Price $86.93 / $86.93 / $86.93	Facility	53	$86.93	$86.93	$86.93
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $277.20 / $575.17 / $1,087.96	Professional		$277.20	$575.17	$1,087.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $564.65 / $749.69 / $1,025.99	Professional		$564.65	$749.69	$1,025.99
United Facility/Professional Facility Modifier Low / Median / High Price $675.00 / $2,297.00 / $5,235.00	Facility		$675.00	$2,297.00	$5,235.00
United Facility/Professional Professional Modifier Low / Median / High Price $561.90 / $773.48 / $1,388.94	Professional		$561.90	$773.48	$1,388.94