Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $337.06 / $2,476.00 / $4,975.00	Facility		$337.06	$2,476.00	$4,975.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $51.69 / $145.41 / $463.91	Facility	52	$51.69	$145.41	$463.91
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $20.68 / $58.16 / $185.56	Facility	53	$20.68	$58.16	$185.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.93 / $221.23 / $476.83	Professional		$98.93	$221.23	$476.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.51 / $108.18 / $173.90	Professional		$87.51	$108.18	$173.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $711.00 / $1,769.00 / $3,943.00	Facility		$711.00	$1,769.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.89 / $247.10 / $448.86	Professional		$103.89	$247.10	$448.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $99.37 / $119.24 / $148.81	Facility		$99.37	$119.24	$148.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $259.08 / $336.80 / $581.79	Professional		$259.08	$336.80	$581.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $179.49 / $581.00 / $1,024.26	Facility		$179.49	$581.00	$1,024.26
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $143.59 / $143.59 / $143.59	Facility	52	$143.59	$143.59	$143.59
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $35.90 / $35.90 / $35.90	Facility	53	$35.90	$35.90	$35.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.28 / $233.81 / $491.11	Professional		$114.28	$233.81	$491.11
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $529.92 / $1,125.59 / $2,703.54	Facility		$529.92	$1,125.59	$2,703.54
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $143.59 / $143.59 / $143.59	Facility	52	$143.59	$143.59	$143.59
Medical Mutual of Ohio Facility/Professional Facility Modifier 53 Low / Median / High Price $35.90 / $35.90 / $35.90	Facility	53	$35.90	$35.90	$35.90
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $119.24 / $246.22 / $470.52	Professional		$119.24	$246.22	$470.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $298.85 / $416.35	Professional		$216.90	$298.85	$416.35
United Facility/Professional Facility Modifier Low / Median / High Price $675.00 / $2,499.00 / $5,235.00	Facility		$675.00	$2,499.00	$5,235.00
United Facility/Professional Professional Modifier Low / Median / High Price $252.01 / $356.25 / $593.53	Professional		$252.01	$356.25	$593.53