Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $2,818.38 / $10,232.93	Facility		$489.78	$2,818.38	$10,232.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $616.60 / $1,318.26	Professional		$257.04	$616.60	$1,318.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $257.04	Professional		$218.78	$218.78	$257.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $3,019.95 / $6,165.95	Facility		$1,000.00	$3,019.95	$6,165.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $354.81 / $602.56	Professional		$275.42	$354.81	$602.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $269.15 / $794.33	Facility		$239.88	$269.15	$794.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $302.00	Professional		$269.15	$269.15	$302.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $616.60 / $1,659.59	Facility		$436.52	$616.60	$1,659.59
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $524.81 / $524.81 / $524.81	Facility	22	$524.81	$524.81	$524.81
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $346.74 / $346.74 / $346.74	Facility	52	$346.74	$346.74	$346.74
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $87.10 / $87.10 / $87.10	Facility	53	$87.10	$87.10	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $562.34 / $1,148.15	Professional		$269.15	$562.34	$1,148.15
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $616.60 / $2,454.71	Facility		$436.52	$616.60	$2,454.71
Medical Mutual of Ohio Facility/Professional Facility Modifier 22 Low / Median / High Price $524.81 / $524.81 / $524.81	Facility	22	$524.81	$524.81	$524.81
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $346.74 / $346.74 / $346.74	Facility	52	$346.74	$346.74	$346.74
Medical Mutual of Ohio Facility/Professional Facility Modifier 53 Low / Median / High Price $87.10 / $87.10 / $87.10	Facility	53	$87.10	$87.10	$87.10
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $524.81 / $1,096.48	Professional		$263.03	$524.81	$1,096.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $245.47	Professional		$32.36	$33.11	$245.47
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $1,479.11	Facility		$100.00	$100.00	$1,479.11
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $676.08 / $1,348.96	Professional		$234.42	$676.08	$1,348.96
United Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $2,290.87 / $4,897.79	Facility		$676.08	$2,290.87	$4,897.79
United Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $524.81 / $1,000.00	Professional		$245.47	$524.81	$1,000.00