Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $480.48 / $1,751.00 / $5,317.72	Facility		$480.48	$1,751.00	$5,317.72
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $1,302.00 / $1,302.00 / $1,302.00	Facility	22	$1,302.00	$1,302.00	$1,302.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $123.91 / $240.24 / $690.21	Facility	52	$123.91	$240.24	$690.21
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $49.56 / $96.10 / $276.08	Facility	53	$49.56	$96.10	$276.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $247.81 / $453.49 / $913.65	Professional		$247.81	$453.49	$913.65
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $49.56 / $87.36 / $134.54	Professional	53	$49.56	$87.36	$134.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $215.37 / $276.37 / $366.84	Professional		$215.37	$276.37	$366.84
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $225.18 / $225.18 / $225.18	Professional	53	$225.18	$225.18	$225.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $919.00 / $2,443.00 / $8,015.00	Facility		$919.00	$2,443.00	$8,015.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $250.87 / $366.83 / $624.33	Professional		$250.87	$366.83	$624.33
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $267.44 / $347.67 / $433.11	Professional		$267.44	$347.67	$433.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $236.67 / $284.00 / $355.01	Facility		$236.67	$284.00	$355.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $412.00 / $535.60 / $937.22	Professional		$412.00	$535.60	$937.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $426.66 / $763.40 / $959.43	Facility		$426.66	$763.40	$959.43
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $341.33 / $341.33 / $341.33	Facility	52	$341.33	$341.33	$341.33
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $85.33 / $85.33 / $85.33	Facility	53	$85.33	$85.33	$85.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $267.67 / $467.49 / $814.26	Professional		$267.67	$467.49	$814.26
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $710.42 / $1,418.06 / $3,527.64	Facility		$710.42	$1,418.06	$3,527.64
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $341.33 / $341.33 / $341.33	Facility	52	$341.33	$341.33	$341.33
Medical Mutual of Ohio Facility/Professional Facility Modifier 53 Low / Median / High Price $85.33 / $85.33 / $85.33	Facility	53	$85.33	$85.33	$85.33
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $267.67 / $449.67 / $805.08	Professional		$267.67	$449.67	$805.08
Medical Mutual of Ohio Facility/Professional Professional Modifier 53 Low / Median / High Price $48.48 / $48.48 / $48.48	Professional	53	$48.48	$48.48	$48.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $388.96 / $530.72 / $723.91	Professional		$388.96	$530.72	$723.91
United Facility/Professional Facility Modifier Low / Median / High Price $707.00 / $2,500.00 / $5,457.00	Facility		$707.00	$2,500.00	$5,457.00
United Facility/Professional Professional Modifier Low / Median / High Price $385.41 / $557.25 / $891.15	Professional		$385.41	$557.25	$891.15