Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $550.88 / $2,816.00 / $9,841.78	Facility		$550.88	$2,816.00	$9,841.78
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $2,564.67 / $2,564.67 / $2,564.67	Facility	22	$2,564.67	$2,564.67	$2,564.67
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $162.03 / $240.93 / $979.50	Facility	52	$162.03	$240.93	$979.50
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $64.81 / $96.37 / $222.56	Facility	53	$64.81	$96.37	$222.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $324.05 / $419.73 / $595.70	Professional		$324.05	$419.73	$595.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $354.08 / $463.46 / $478.90	Professional		$354.08	$463.46	$478.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $918.00 / $2,114.00 / $8,800.00	Facility		$918.00	$2,114.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $248.59 / $340.72 / $521.47	Professional		$248.59	$340.72	$521.47
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $349.14 / $349.14 / $349.14	Professional		$349.14	$349.14	$349.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $308.97 / $370.76 / $463.46	Facility		$308.97	$370.76	$463.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $308.97 / $401.66 / $716.37	Professional		$308.97	$401.66	$716.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $373.67 / $1,558.00 / $2,119.01	Facility		$373.67	$1,558.00	$2,119.01
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $291.99 / $291.99 / $291.99	Facility	52	$291.99	$291.99	$291.99
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $73.00 / $73.00 / $73.00	Facility	53	$73.00	$73.00	$73.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $287.52 / $425.87 / $690.68	Professional		$287.52	$425.87	$690.68
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $562.00 / $1,353.67 / $3,169.03	Facility		$562.00	$1,353.67	$3,169.03
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $291.99 / $291.99 / $291.99	Facility	52	$291.99	$291.99	$291.99
Medical Mutual of Ohio Facility/Professional Facility Modifier 53 Low / Median / High Price $73.00 / $73.00 / $73.00	Facility	53	$73.00	$73.00	$73.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $288.89 / $428.89 / $650.70	Professional		$288.89	$428.89	$650.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $293.54 / $386.69 / $521.22	Professional		$293.54	$386.69	$521.22
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 $294.24 / $417.11 / $686.33	Professional		$294.24	$417.11	$686.33