Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,758.00 / $9,401.33 / $23,286.07	Facility		$3,758.00	$9,401.33	$23,286.07
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,758.00 / $3,758.00 / $3,758.00	Facility	22	$3,758.00	$3,758.00	$3,758.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $329.37 / $489.77 / $1,087.68	Facility	52	$329.37	$489.77	$1,087.68
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $131.75 / $195.91 / $435.07	Facility	53	$131.75	$195.91	$435.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $620.03 / $826.34 / $2,175.35	Professional		$620.03	$826.34	$2,175.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $574.76 / $757.92 / $889.94	Professional		$574.76	$757.92	$889.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,938.00 / $4,724.00 / $25,522.00	Facility		$1,938.00	$4,724.00	$25,522.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $571.99 / $809.33 / $1,342.83	Professional		$571.99	$809.33	$1,342.83
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $713.71 / $713.71 / $827.40	Professional		$713.71	$713.71	$827.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $631.60 / $757.92 / $947.40	Facility		$631.60	$757.92	$947.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $631.60 / $821.08 / $1,464.39	Professional		$631.60	$821.08	$1,464.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $581.00 / $3,969.14 / $5,819.95	Facility		$581.00	$3,969.14	$5,819.95
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $594.13 / $594.13 / $594.13	Facility	52	$594.13	$594.13	$594.13
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $148.53 / $148.53 / $148.53	Facility	53	$148.53	$148.53	$148.53
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $74.27 / $74.27 / $74.27	Facility	AS	$74.27	$74.27	$74.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $626.05 / $884.24 / $1,367.39	Professional		$626.05	$884.24	$1,367.39
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $4,041.48 / $8,030.44 / $21,467.28	Facility		$4,041.48	$8,030.44	$21,467.28
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $594.13 / $594.13 / $594.13	Facility	52	$594.13	$594.13	$594.13
Medical Mutual of Ohio Facility/Professional Facility Modifier 53 Low / Median / High Price $148.53 / $148.53 / $148.53	Facility	53	$148.53	$148.53	$148.53
Medical Mutual of Ohio Facility/Professional Facility Modifier AS Low / Median / High Price $74.27 / $74.27 / $74.27	Facility	AS	$74.27	$74.27	$74.27
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $622.66 / $904.45 / $1,350.20	Professional		$622.66	$904.45	$1,350.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $72.27 / $609.47 / $893.00	Professional		$72.27	$609.47	$893.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,275.00 / $8,105.00 / $12,871.00	Facility		$1,275.00	$8,105.00	$12,871.00
United Facility/Professional Professional Modifier Low / Median / High Price $581.23 / $801.28 / $1,375.46	Professional		$581.23	$801.28	$1,375.46